Dual-energy CT for detection of contrast enhancement or leakage within high-density haematomas in patients with intracranial haemorrhage

Neuroradiology. 2014 Apr;56(4):291-5. doi: 10.1007/s00234-014-1333-3. Epub 2014 Feb 8.


Introduction: Our study aimed to elucidate the diagnostic performance of dual-energy CT (DECT) in the detection of contrast enhancement in intracranial haematomas (ICrH) with early phase dual-energy computed tomography angiography (CTA) and compare the results with those obtained by delayed CT enhancement.

Methods: Thirty-six patients with ICrH were retrospectively included in this study. All patients had undergone single-energy non-contrast CT and contrast-enhanced dual-source DECT. DECT images were post-processed with commercial software, followed by obtaining iodine images and virtual non-contrast images and generating combined images that created the impression of 120-kVp images. Two neuroradiologists, blinded to the patients' data, reviewed two reading sessions: session A (non-contrast CT and combined CT) and session B (non-contrast CT, combined CT, and iodine images) for detection of contrast enhancement in the haematomas.

Results: Contrast leakage or enhancement was detected in 23 (57.5 %) out of 40 haemorrhagic lesions in 36 patients on delayed CT. Three enhanced lesions were depicted only in the DECT iodine images. The sensitivity, specificity, positive predictive value, and negative predictive value of session A were 82.6, 94.1, 95.0, and 80.0 %, respectively, and those of session B were 95.7, 94.1, 95.7, and 94.1 %, respectively.

Conclusion: DECT emphasised the iodine enhancement and facilitated the detection of contrast enhancement or leakage.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cerebral Angiography / methods*
  • Contrast Media / adverse effects
  • Contrast Media / therapeutic use
  • Extravasation of Diagnostic and Therapeutic Materials / diagnostic imaging*
  • Extravasation of Diagnostic and Therapeutic Materials / etiology*
  • Female
  • Hamartoma / complications
  • Hamartoma / diagnostic imaging*
  • Humans
  • Intracranial Hemorrhages / complications
  • Intracranial Hemorrhages / diagnostic imaging*
  • Male
  • Middle Aged
  • Observer Variation
  • Radiography, Dual-Energy Scanned Projection / methods*
  • Reproducibility of Results
  • Retrospective Studies
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed / methods*
  • Young Adult


  • Contrast Media