Iodine contrast extravasation post-thrombectomy

Case contributed by Ahmed Adam Eltayeb , 17 Oct 2023
Diagnosis certain
Changed by Arlene Campos, 18 Oct 2023
Disclosures - updated 9 Jun 2023: Nothing to disclose

Updates to Case Attributes

Presentation was changed:
Acute left side-side body weakness. The patient was diagnosed with a right MCA infraction, and he underwent immediate thrombectomy.
Edit Without Moderation was set to true.
Body was changed:

In Follow-up thefollowing up on a patient with a stroke after a mechanical thrombectomy, in some timesometimes you find challengeit challenging to differentiate between the contrast staining material and bleeding .Hence by. Hence, performing the Dual energydual-energy CT it can help to differentiate between them.

By doing further follow up-up with plain CT, the contrast material it will fade quickly; however, the haemorrhage persistpersists.

  • -<p>In Follow-up the patient with stroke after mechanical thrombectomy, in some time you find challenge to differentiate between the contrast staining material and bleeding .Hence by performing the Dual energy CT it can help to differentiate between them.</p><p>By doing further follow up with plain CT the contrast material it will fade quickly however the haemorrhage persist.</p>
  • +<p>In following up on a patient with a stroke after a mechanical thrombectomy, sometimes you find it challenging to differentiate between the contrast staining material and bleeding. Hence, performing the dual-energy CT can help differentiate between them.</p><p>By doing further follow-up with plain CT, the contrast material will fade quickly; however, the haemorrhage persists.</p>
Status changed from pending review to published (public).
Published At was set to 2023-10-18T07:10:52.430Z.

References changed:

  • 1. Bonatti M, Lombardo F, Zamboni G et al. Iodine Extravasation Quantification on Dual-Energy CT of the Brain Performed After Mechanical Thrombectomy for Acute Ischemic Stroke Can Predict Hemorrhagic Complications. AJNR Am J Neuroradiol. 2018;39(3):441-7. <a href="https://doi.org/10.3174/ajnr.A5513">doi:10.3174/ajnr.A5513</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/29348131">Pubmed</a>
  • 2. Chen S, Zhang J, Quan X et al. Diagnostic Accuracy of Dual-Energy Computed Tomography to Differentiate Intracerebral Hemorrhage from Contrast Extravasation After Endovascular Thrombectomy for Acute Ischemic Stroke: Systematic Review and Meta-Analysis. Eur Radiol. 2022;32(1):432-41. <a href="https://doi.org/10.1007/s00330-021-08212-1">doi:10.1007/s00330-021-08212-1</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/34327578">Pubmed</a>
  • 1.https://radiopaedia.org/articles/dual-energy-ct-2 2.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7655335/#:~:text=Conclusions-,Iodine%20extravasation%20quantification%20on%20dual%2Denergy%20CT%20performed%20immediately%20after,excellent%20sensitivity%20and%20moderate%20specificity. 3.https://pubmed.ncbi.nlm.nih.gov/34327578/#:~:text=The%20pooled%20mean%20sensitivity%2C%20specificity,0.98%20to%201)%2C%20respectively.
  • 1.https://radiopaedia.org/articles/dual-energy-ct-2 2.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7655335/#:~:text=Conclusions-,Iodine%20extravasation%20quantification%20on%20dual%2Denergy%20CT%20performed%20immediately%20after,excellent%20sensitivity%20and%20moderate%20specificity. 3.https://pubmed.ncbi.nlm.nih.gov/34327578/#:~:text=The%20pooled%20mean%20sensitivity%2C%20specificity,0.98%20to%201)%2C%20respectively.

Updates to Study Attributes

Findings was changed:

Follow up Dual A follow-up dual-energy CT of the brain was performedimmediately after endovascular thrombectomy.

ItsIt showed cerebral gyriform hyperdensities within the right temporoparietal cortical region as well as within the right sylvianSylvian fissure and interpeduncular cistern in both the iodine overlay map (IOM), and virtual monoenergetic non-contrast images (VNC).

Features are in favoring of favour contrast staining rather than bleeding.

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