Edema Map Allows Earlier Infarction Visualization After Stroke Therapy

Edema visualization with an edema map (EM) allows for higher contrast and better early infarction detection, according to a study published in the journal European Radiology.

Researchers from the United Kingdom and Austria investigated whether dual-energy computed tomography (DECT) reconstructions optimised for edema visualisation facilitated improved detection of early infarctions after endovascular stroke therapy (EST).

Twenty-one women and 25 men, mean age 63 years, participated in the study. The researchers evaluated brain window (BW), virtual non-contrast (VNC) and modified VNC series based on a three-material decomposition technique optimised for EM. Follow-up imaging was used as the standard for comparison. Contralateral side to infarction differences in density (CIDs) were determined. Infarction detectability was assessed by two blinded readers, as well as image noise and contrast using Likert scales.

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The results showed the highest CIDs were found in the EM series (73.3 ± 49.3 HU), compared with the BW (-1.72 ± 13.29 HU) and the VNC (8.30 ± 4.74 HU) series. The EM was found to have the highest infarction detection rates (area under the curve: 0.97 versus 0.54 and 0.90) with a cut-off value of < 50.7 HU, despite slightly more pronounced image noise. The location of the infarction did not affect detectability.

The researchers concluded that the EM series allowed for better higher contrast and early infarction detection than the VNC or BW series after EST.