Frontiers in neurology · 2025
Photon counting CT vs. flat-panel CT in the evaluation of enhancement patterns in chronic subdural hematoma after middle meningeal artery embolization.
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Maurer Christoph J, Behrens Lars, Schiele Stefan, Zaki Mahmoud, Quint Guilherme, Wolfert Christina, Sommer Björn, Stangl Franz J, Berlis Ansgar
Аннотация
INTRODUCTION: Middle meningeal artery embolization is a treatment option for chronic subdural hematoma (cSDH), but data on post-procedural imaging interpretation remain limited. This study investigates whether specific enhancement patterns can predict radiological outcomes and evaluates the utility of photon-counting computed tomography (PCCT) in distinguishing contrast enhancement from hemorrhage.
METHODS: We retrospectively analyzed 105 cSDHs imaged with either PCCT or flat-panel CT immediately after embolization. Two independent raters assessed enhancement patterns; diagnostic confidence and interrater agreement were evaluated.
RESULTS: PCCT demonstrated higher diagnostic confidence and interrater reliability than flat-panel CT. Internal enhancement and fluid-fluid levels were significantly associated with hematoma persistence or recurrence.
DISCUSSION: PCCT enhances post-embolization imaging assessment in cSDH. Specific enhancement patterns may serve as imaging biomarkers to identify patients at increased risk for unfavorable radiological outcomes.
METHODS: We retrospectively analyzed 105 cSDHs imaged with either PCCT or flat-panel CT immediately after embolization. Two independent raters assessed enhancement patterns; diagnostic confidence and interrater agreement were evaluated.
RESULTS: PCCT demonstrated higher diagnostic confidence and interrater reliability than flat-panel CT. Internal enhancement and fluid-fluid levels were significantly associated with hematoma persistence or recurrence.
DISCUSSION: PCCT enhances post-embolization imaging assessment in cSDH. Specific enhancement patterns may serve as imaging biomarkers to identify patients at increased risk for unfavorable radiological outcomes.