Abstract
BACKGROUND
Electron density (ED) imaging has shown the ability to discriminate between different soft tissue components in preliminary studies. We hypothesized that ED might improve the identification of brain tissue abnormalities in patients with large vessel occlusion acute ischemic stroke (AIS).
METHODS
We retrospectively included a series of patients with large vessel occlusion AIS comprising the middle cerebral artery (MCA) territory. All patients underwent non-contrast brain computed tomography (CT) and CT angiography using a dual-layer spectral CT scanner. Using a multiparameter display including conventional CT images (Hounsfield units, HU), ED relative to water (%EDW), and effective atomic number (Zeff), we evaluated the brain tissue territory distal to the occlusion, and the contralateral hemisphere.
RESULTS
Twenty-eight patients were included, with a mean age of 75.7 ± 10.9 years. The brain tissue distal to the MCA occlusion showed significant differences compared with the contralateral hemisphere only using conventional CT (25.0 ± 2.7 HU vs. 29.2 ± 2.4 HU, p p p = 0.36) showed similar values. ED imaging was associated with a significantly higher diagnostic confidence for the identification of abnormal findings, both for the evaluation of the hyperdense MCA (conventional CT 3.46 ± 1.3 vs. ED imaging 4.79 ± 0.4 vs. Zeff imaging 2.07 ± 1.0, p p < 0.0001).
CONCLUSIONS
In this study, ED imaging enabled a more confident identification of brain tissue changes related to large vessel occlusion AIS compared with conventional CT imaging.