APPLICATION OF SPECTRAL CT IN DIFFERENTIATING INTRACRANIAL HEMORRHAGE FROM CONTRAST EXTRAVASATION AFTER MECHANICAL THROMBECTOMY AT THONG NHAT HOSPITAL

Trần Thị Hậu 1 , , Huỳnh Nguyên Thuận 1 , Bùi Thị Thanh Tâm 1 , Đỗ Võ Công Nguyên 1
1 Thong Nhat Hospital image/svg+xml
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DOI
10.63947/bvtn.v2i9.19
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Published
2026-10-01
Issue Vol. 2 No. 9 (2026): A Major Step Forward in Specialized Care: A Milestone Marked by the First Liver Transplant at Thong Nhat Hospital
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Original Research

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Trần TH, Huỳnh NT, Bùi TTT, Đỗ VCN. APPLICATION OF SPECTRAL CT IN DIFFERENTIATING INTRACRANIAL HEMORRHAGE FROM CONTRAST EXTRAVASATION AFTER MECHANICAL THROMBECTOMY AT THONG NHAT HOSPITAL. JHA [Internet]. Vietnam; 2026 Oct. 1 [cited 2026 Oct. 16];2(9):142–147. https://tcsuckhoelaohoa.vn/bvtn/article/view/233 doi: 10.63947/bvtn.v2i9.19
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Abstract

After mechanical thrombectomy, hyperattenuating areas on non-contrast CT may represent intracranial hemorrhage, contrast extravasation, or both, and conventional CT may not reliably distinguish them. This article aims to describe the role of spectral/dual-energy CT in this setting at Thong Nhat Hospital. This article describes the principles and applications of virtual monoenergetic images (MonoE), virtual non-contrast (VNC) images, and iodine density maps generated on a Spectral CT 7500 system, illustrated by post-thrombectomy clinical cases from Thong Nhat Hospital. Iodine-containing lesions change more across MonoE energy levels, decrease or disappear on VNC images, and are visible on iodine density maps. Blood components tend to persist on VNC and show less energy-dependent attenuation change; mixed lesions require integrated assessment of multiple spectral reconstructions. Spectral CT improves early differentiation between intracranial hemorrhage and contrast extravasation, supporting post-procedural antithrombotic decisions and follow-up. Findings should be interpreted with the clinical context and follow-up imaging rather than a single universal iodine concentration threshold.

Keywords

spectral CT dual-energy CT mechanical thrombectomy intracranial hemorrhage contrast extravasation iodine density map

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