ArticleDiagnostic and interventional radiology (Ankara, Turkey)2026
The hematoma measurement accuracy of dual-energy computed tomography angiography in spontaneous intracerebral hemorrhage.
Article in Diagnostic and interventional radiology (Ankara, Turkey), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo investigate the accuracy of hematoma volume (V), surface area (S), and surface regularity (SR) measured on dual-energy computed tomography angiography (DECTA), using non-contrast computed tomography (NCCT) as the reference standard.
methodsA total of 129 patients with spontaneous intracerebral hemorrhage (sICH) who underwent both NCCT and DECTA scans were retrospectively studied. Patients were stratified by V: Group 1 (< 30 mL), Group 2 (30-60 mL), and Group 3 (> 60 mL); and by morphology: regular, irregular, and lobular. DECTA data were post-processed to generate conventional computed tomography angiography (CTA) and 60 keV virtual monoenergetic imaging (VMI). These, along with NCCT images, were imported into 3D Slicer software to obtain V and S; SR was subsequently calculated. Deviation percentages (ΔV, ΔS, ΔSR) of conventional CTA and 60 keV VMI relative to NCCT were calculated. We assessed correlations using simple linear regression, compared different modalities with unpaired t-tests or Mann-Whitney U tests, evaluated agreement via Bland-Altman analysis, and compared deviation percentages across groups using one-way analysis of variance or Kruskal-Wallis H tests. Inter-reader consistency was assessed using the intraclass correlation coefficient (ICC).
resultsThe average V was 28.86±24.15 mL. All ICCs were excellent (0.991-0.999). Strong correlations were found for V and S between conventional CTA/60 keV VMI and NCCT (r: 0.987-0.996). Bland-Altman analysis for V showed mean biases of 0.21 mL (conventional CTA) and -0.04 mL (60 keV VMI) against NCCT, with 95% limits of agreement of -4.72 to 5.14 mL and -4.51 to 4.43 mL, respectively. However, SR values from both conventional CTA and 60 keV VMI were significantly lower than those from NCCT (all
conclusionHematoma volume measurements from DECTA show good agreement with NCCT measurements, suggesting potential utility for follow-up assessment in certain clinical scenarios. However, DECTA-derived SR measurements are significantly lower than those from NCCT. Volume measurement accuracy of conventional CTA was higher for large hematomas (> 60 mL). CLINICAL SIGNIFICANCE: Accurate hematoma measurement is crucial for prognosis and management in sICH. This study indicates that V measurements from DECTA are comparable to those from NCCT in certain clinical scenarios, offering potential added value when CTA is clinically indicated.
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