The Study Of Dual Source CT Dual Energy CT Angiography Imaging For Detecting Intracranial Active Bleeding

Objective: To investigate Dual source CT dual energy CTA imaging for detection the positive rate of intracranial active bleeding,in order to improve the level of diagnosis.Methods: Retrospective collection of 225 cases of cerebral hemorrhage patients with dual energy CTA images(neck to head) and clinical datas in Nanhua university first affiliated hospital from October 2013 to June 2014. According to the include and exclude standard,117 cases were obtained. Each case after Image post-processing,we got non-linear blending of mixed k V image, Fusion iodine overlay image, virtual noncontrast image, bone removed three-dimensional vascular image, Using final clinical results as the gold standard. Analysis of image features, including direct signs of hematoma(volume, shape, location, whether to break into ventricle or subarachnoid space), as well as the extravasation of contrast( spot sign). Discussed the image features of hematoma in patients with active bleeding, Compared the new and traditional CTA techniques to assess the diagnostic value of active bleeding; Screened the risk factors in patients with active bleeding.Results: Compared to conventional CTA enhance image,the new technical CTA Fusion iodine overlay image can improve the detection sensitivity of active bleeding(92.6% VS 62.7%,P< 0.05), and difference of the detection specificity is not significant(93.3% VS 96.7%, P> 0.05).There was no statistically significant difference in the diagnosis of cerebral hemorrhage between virtual unenhanced images and conventional unenhanced images,the agreemen of two diagnosis methods is stronger(K=0.791,P<0.001).We found the following factors between the two groups were Statistical differences: irregular hematoma shape, hematoma broken into ventricle or subarachnoid, volume≥30ml, history of hypertension ≥10 year, taking anti-platelet medication history, especially taking anti-platelet medication historywere independent factors.Conclusion: Dual energy dual energy fusion Iodine overlay imaging can improve diagnostic sensitivity of active bleeding in the brain,many image features of hematoma and clinical indicators associated with the activity bleeding in the brain. Dual energy fusion iodine imaging can improve the detection rate of active bleeding.virtual unenhanced imaging can effectively diagnose intracranial hemorrhage.Within 6 hours after patients onset,Of the highest detection rate of active bleeding,Dual energy fusion iodine imaging can help screening of patients for early treatment.Patients with related risk factors of activity bleeding, should pay close attention to evaluate the progress of the disease within 6 hours after onset,in a timely mannerc donging double energy CTA examination to guide the treatment of the next step.