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PT  - JOURNAL ARTICLE
AU  - Bodanapally, U.K.
AU  - Shanmuganathan, K.
AU  - Issa, G.
AU  - Dreizin, D.
AU  - Li, G.
AU  - Sudini, K.
AU  - Fleiter, T.R.
TI  - Dual-Energy CT in Hemorrhagic Progression of Cerebral Contusion: Overestimation of Hematoma Volumes on Standard 120-kV Images and Rectification with Virtual High-Energy Monochromatic Images after Contrast-Enhanced Whole-Body Imaging
AID  - 10.3174/ajnr.A5558
DP  - 2018 Apr 01
TA  - American Journal of Neuroradiology
PG  - 658--662
VI  - 39
IP  - 4
4099  - http://www.ajnr.org/content/39/4/658.short
4100  - http://www.ajnr.org/content/39/4/658.full
SO  - Am. J. Neuroradiol.2018 Apr 01; 39
AB  - BACKGROUND AND PURPOSE: In patients with hemorrhagic contusions, hematoma volumes are overestimated on follow-up standard 120-kV images obtained after contrast-enhanced whole-body CT. We aimed to retrospectively determine hemorrhagic progression of contusion rates on 120-kV and 190-keV images derived from dual-energy CT and the magnitude of hematoma volume overestimation.MATERIALS AND METHODS: We retrospectively analyzed admission and follow-up CT studies in 40 patients with hemorrhagic contusions. After annotating the contusions, we measured volumes from admission and follow-up 120-kV and 190-keV images using semiautomated 3D segmentation. Bland-Altman analysis was used for hematoma volume comparison.RESULTS: On 120-kV images, hemorrhagic progression of contusions was detected in 24 of the 40 patients, while only 17 patients had hemorrhagic progression of contusions on 190-keV images (P = .008). Hematoma volumes were systematically overestimated on follow-up 120-kV images (9.68 versus 8 mm3; mean difference, 1.68 mm3; standard error, 0.37; P &amp;lt; .001) compared with 190-keV images. There was no significant difference in volumes between admission 120-kV and 190-keV images. Mean and median percentages of overestimation were 29% (95% CI, 18–39) and 22% (quartile 3 − quartile 1 = 36.8), respectively.CONCLUSIONS: The 120-kV images, which are comparable with single-energy CT images, significantly overestimated the hematoma volumes, hence the rate of hemorrhagic progression of contusions, after contrast-enhanced whole-body CT. Hence, follow-up of hemorrhagic contusions should be performed on dual-energy CT, and 190-keV images should be used for the assessment of hematoma volumes.DECTdual-energy CTHPChemorrhagic progression of contusionSECTsingle-energy CTWBCTwhole-body CT