RT Journal Article
SR Electronic
T1 Metallic Hyperdensity Sign on Noncontrast CT Immediately after Mechanical Thrombectomy Predicts Parenchymal Hemorrhage in Patients with Acute Large-Artery Occlusion
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 661
OP 667
DO 10.3174/ajnr.A6008
VO 40
IS 4
A1 C. Xu
A1 Y. Zhou
A1 R. Zhang
A1 Z. Chen
A1 W. Zhong
A1 X. Gong
A1 X. Ding
A1 M. Lou
YR 2019
UL http://www.ajnr.org/content/40/4/661.abstract
AB 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.HThemorrhagic transformationMTmechanical thrombectomyPHparenchymal hemorrhage