Accuracy and usefulness of dual-energy computed tomography after mechanical thrombectomy: A retrospective study

Hemorrhagic complications are serious concern following mechanical thrombectomy (MT), making early identification crucial. Dual Energy Computed Tomography (DECT)is considered a potentially effective tool for postoperative evaluation, as it minimizes the effects of contrast leakage. This study examined the accuracy and usefulness of the results.

We retrospectively identified 118 patients who had DECT immediately after MT at our institution between April 2020 and March 2024. Follow-up imaging with either CT or Magnetic Resonance Imaging was conducted the day after MT to evaluate consistency with the immediate postoperative DECT findings.

Of the 118 cases, 39 were suspected to have bleeding based on immediate postoperative DECT, and 37 of these were confirmed to have actual bleeding on imaging evaluation the day after MT. Two cases were false positive on DECT. On the other hand, there was one case that bleeding was not initially suspected on immediate postoperative DECT, but was later identified on subsequent imaging. The overall sensitivity and specificity of DECT were 97.4 % and 97.5 %, respectively.

Immediate postoperative DECT demonstrated high reliability, with excellent sensitivity and specificity. DECT may serve as an effective indicator for secondary prevention management and blood pressure control during the immediate postoperative period following MT.