Abstract
BACKGROUND AND PURPOSE: Parenchymal hemorrhage is a severe complication following mechanical recanalization in patients with acute ischemic stroke with large-vessel occlusion. This study aimed to assess whether the metallic hyperdensity sign on noncontrast CT performed immediately after mechanical thrombectomy can predict parenchymal hemorrhage at 24 hours.
MATERIALS AND METHODS: We included consecutive patients with acute ischemic stroke with large-vessel occlusion who underwent noncontrast CT immediately after mechanical thrombectomy between January 2014 and September 2018. The metallic hyperdensity sign was defined as a nonpetechial intracerebral hyperdense lesion (diameter, ≥1 cm) in the basal ganglia and a maximum CT density of >90 HU. The sensitivity, specificity, and positive and negative predictive values of the metallic hyperdensity sign in predicting parenchymal hemorrhage were calculated.
RESULTS: A total of 198 patients were included. The metallic hyperdensity sign was found in 59 (29.7%) patients, and 51 (25.7%) patients had parenchymal hemorrhage at 24 hours. Patients with the metallic hyperdensity sign are more likely to have parenchymal hemorrhage than those without it (76.3% versus 4.3%, P < .001). The sensitivity, specificity, positive predictive value, and negative predictive value of the metallic hyperdensity sign in predicting parenchymal hemorrhage were 88.2%, 90.5%, 76.3%, and 95.7%, respectively.
CONCLUSIONS: The presence of the metallic hyperdensity sign on noncontrast CT performed immediately after mechanical thrombectomy in patients with large-vessel occlusion could predict the occurrence of parenchymal hemorrhage at 24 hours, which might be helpful in postinterventional management within 24 hours after mechanical thrombectomy.
ABBREVIATIONS:
- HT
- hemorrhagic transformation
- MT
- mechanical thrombectomy
- PH
- parenchymal hemorrhage
Footnotes
Disclosures: Min Lou—RELATED: Grant: National Natural Science Foundation of China (81471170 and 81622017), Fundamental Research Funds for the Central Universities (2017XZZX002-09), and the National Key Research and Development Program of China (2016YFC1301503).* *Money paid to the institution.
This study was supported by the National Natural Science Foundation of China (81622017, 81471170), the National Key Research and Development Program of China (2016YFC1301503), the Science Technology Department of Zhejiang Province (2018C04011), and Fundamental Research Funds for the Central Universities (2017XZZX002-09).
- © 2019 by American Journal of Neuroradiology
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