Dual-energy CT in hemorrhagic progression of cerebral contusion: Overestimation of hematoma volumes on standard 120-kv images and rectification with virtual high-energy monochromatic images after contrast-enhanced whole-body imaging

Abstract

BACKGROUND AND PURPOSE: In patients with hemorrhagic contusions, hematoma volumes are overestimated on follow-up standard 120-kV images obtained after contrast-enhanced whole-body CT. We aimed to retrospectively determine hemorrhagic progression of contusion rates on 120-kV and 190-keV images derived from dual-energy CT and the magnitude of hematoma volume overestimation. MATERIALS AND METHODS: We retrospectively analyzed admission and follow-up CT studies in 40 patients with hemorrhagic contusions. After annotating the contusions, we measured volumes from admission and follow-up 120-kV and 190-keV images using semiautomated 3D segmentation. Bland-Altman analysis was used for hematoma volume comparison. RESULTS: On 120-kV images, hemorrhagic progression of contusions was detected in 24 of the 40 patients, while only 17 patients had hemorrhagic progression of contusions on 190-keV images (P =.008). Hematoma volumes were systematically overestimated on follow-up 120-kV images (9.68 versus 8 mm; mean difference, 1.68 mm; standard error, 0.37; P