GIÁ TRỊ HÌNH ẢNH CẮT LỚP VI TÍNH HAI MỨC NĂNG  LƯỢNG TRONG TIÊN ĐOÁN NGUY CƠ XUẤT HUYẾT NÃO  SAU LẤY HUYẾT KHỐI CƠ HỌC Ở BỆNH NHÂN ĐỘT QUỴ  NHỒI MÁU NÃO CẤP TUẦN HOÀN TRƯỚC VÀ TUẦN  HOÀN SAU TẠI BỆNH VIỆN QUÂN Y 175

Thương Trương Minh; Anh Đặng Thanh Tú; Giang Lê Văn; Văn Phan Đình; Trang Nguyễn Võ Thu; Vũ Trần Minh; Bình Phạm Thị Hải; Minh Võ Thanh

doi:10.59354/ydth175.2025.404

Authors

Thương Trương Minh Bệnh viện Quân y 175
Anh Đặng Thanh Tú Bệnh viện Quân y 175
Giang Lê Văn Bệnh viện Quân y 175
Văn Phan Đình Bệnh viện Quân y 175
Trang Nguyễn Võ Thu Bệnh viện Quân y 175
Vũ Trần Minh Bệnh viện Quân y 175
Bình Phạm Thị Hải Bệnh viện Quân y 175
Minh Võ Thanh Bệnh viện Quân y 175

DOI:

https://doi.org/10.59354/ydth175.2025.404

Keywords:

Dual-energy CT, acute ischemic stroke, intracerebral hemorrhage, endovascular thrombectomy

Abstract

Objective: To evaluate the predictive value of qualitative features and quantitative indices derived from parenchymal contrast staining (CS) and from the superior sagittal sinus (SSS) on dual-energy CT (DECT) for post-procedural intracerebral hemorrhage (ICH) after endovascular thrombectomy (EVT) in acute ischemic stroke patients.

Materials and Methods: We conducted a retrospective–prospective study including 30 patients with acute ischemic stroke who underwent EVT and DECT within 24 hours post-procedure at Military Hospital 175 between July 2024 and July 2025. Predictive performance of qualitative CS characteristics and quantitative indices from CS regions and the SSS were analyzed for association with post-EVT ICH.

Results: ICH occurred in 6 of 30 patients (20%). Significant DECT predictors of ICH included mixed CS distribution pattern, the “bright spot” sign on iodine overlay maps, a maximum SSS attenuation at 120 kV <52.7 HU (AUC=0,847; sensitivity 66.7%, specificity 100%), and a relative iodine concentration compared with SSS >218% (AUC=0.978; sensitivity 100%, specificity 89%).

Conclusion: DECT provides high predictive value for post-EVT ICH using both qualitative features and quantitative parameters from CS regions and the SSS.

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