Detection of Hyperdense Arterial Sign in Acute Ischemic Stroke with Dual-Energy Computed Tomography: Optimal Combination with X-ray Energy and Slice Thickness.

IF 2.2 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Tomography Pub Date : 2024-02-28 DOI:10.3390/tomography10030028

Kyo Noguchi, Aki Kido, Norihito Naruto, Mariko Doai, Toshihide Itoh, Daina Kashiwazaki, Naoki Akioka, Satoshi Kuroda

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Abstract

Background: The hyperdense artery sign (HAS) in acute ischemic stroke (AIS) is considered an important marker of a thrombus on computed tomography (CT). An advantage of scanning with dual-energy CT (DECT) is its ability to reconstruct CT images with various energies using the virtual monochromatic imaging (VMI) technique. The aim of this study was to investigate the optimal combination of X-ray energy and slice thickness to detect HASs on DECT.

Methods: A total of 32 patients with confirmed occlusion of the horizontal (M1) portion of the middle cerebral artery were included in this study. Modified contrast-to-noise ratio (modified CNR) analysis was used as a method for evaluating HASs in AIS. A region of interest (ROI) was set as an HAS, the M1 portion, and an approximately 2 cm diameter ROI was set as the background including the HAS and measured. CT images with X-ray energies from 40 to 190 keV, with increments of 10 keV, were reconstructed based on VMI with 1, 2, and 3 mm slice thicknesses.

Results: The top five combinations of X-ray energy and slice thickness in descending order of the mean HAS-modified CNR were as follows: Rank 1, 60 keV-1 mm; Rank 2, 70 keV-1 mm; Rank 3, 60 keV-2 mm; Rank 4, 80 keV-2 mm; Rank 5, 60 keV-3 mm.

Conclusions: Our study showed that the optimal combination to detect an HAS was 60 keV and a 1 mm slice thickness on DECT.

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利用双能量计算机断层扫描检测急性缺血性脑卒中的高密度动脉标志：X 射线能量与切片厚度的最佳组合。

背景：急性缺血性卒中（AIS）的动脉高密度征（HAS）被认为是计算机断层扫描（CT）中血栓的重要标志。使用双能量 CT（DECT）扫描的优势在于它能利用虚拟单色成像（VMI）技术重建不同能量的 CT 图像。本研究旨在探讨 X 射线能量和切片厚度的最佳组合，以便在 DECT 上检测 HAS：本研究共纳入 32 例确诊大脑中动脉水平（M1）部分闭塞的患者。采用改良对比噪声比（modified contrast-to-noise ratio，modified CNR）分析作为评估 AIS 中 HASs 的方法。将一个感兴趣区（ROI）设定为 HAS，即 M1 部分，并将一个直径约 2 厘米的 ROI 设定为包括 HAS 的背景并进行测量。根据切片厚度为 1、2 和 3 毫米的 VMI，重建了 X 射线能量为 40 至 190 千伏安（增量为 10 千伏安）的 CT 图像：X 射线能量和切片厚度的平均 HAS 修正 CNR 从大到小排列的前五种组合如下：排名 1：60 keV-1 mm；排名 2：70 keV-1 mm；排名 3：60 keV-2 mm；排名 4：80 keV-2 mm；排名 5：60 keV-3 mm：我们的研究表明，DECT 检测 HAS 的最佳组合是 60 keV 和 1 mm 切片厚度。

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来源期刊

Tomography Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

2.70

自引率

10.50%

发文量

222

期刊介绍： TomographyTM publishes basic (technical and pre-clinical) and clinical scientific articles which involve the advancement of imaging technologies. Tomography encompasses studies that use single or multiple imaging modalities including for example CT, US, PET, SPECT, MR and hyperpolarization technologies, as well as optical modalities (i.e. bioluminescence, photoacoustic, endomicroscopy, fiber optic imaging and optical computed tomography) in basic sciences, engineering, preclinical and clinical medicine. Tomography also welcomes studies involving exploration and refinement of contrast mechanisms and image-derived metrics within and across modalities toward the development of novel imaging probes for image-based feedback and intervention. The use of imaging in biology and medicine provides unparalleled opportunities to noninvasively interrogate tissues to obtain real-time dynamic and quantitative information required for diagnosis and response to interventions and to follow evolving pathological conditions. As multi-modal studies and the complexities of imaging technologies themselves are ever increasing to provide advanced information to scientists and clinicians. Tomography provides a unique publication venue allowing investigators the opportunity to more precisely communicate integrated findings related to the diverse and heterogeneous features associated with underlying anatomical, physiological, functional, metabolic and molecular genetic activities of normal and diseased tissue. Thus Tomography publishes peer-reviewed articles which involve the broad use of imaging of any tissue and disease type including both preclinical and clinical investigations. In addition, hardware/software along with chemical and molecular probe advances are welcome as they are deemed to significantly contribute towards the long-term goal of improving the overall impact of imaging on scientific and clinical discovery.