Work

Enhancing prediction of parenchymal hemorrhage type 2 after endovascular treatment in acute ischemic stroke using dual-phase CTA

Year: 2025

Type: article

Abstract: OBJECTIVE: To evaluate the effectiveness of dual-phase CT angiography (CTA) in predicting parenchymal hemorrhage type 2 (PH2) following endovascular thrombectomy (EVT) in patients with acute ischemic stroke (AIS). METHODS: A retrospective analysis was conducted across two centers, including 232 AIS patients who underwent EVT. Three predictive models were developed: a clinical model (Model C), a clinical model incorporating single-phase CTA data (Model CS), and a clinical model incorporating dual-phase CTA data (Model CD). The performance of these models in predicting PH2 occurrence post-EVT was assessed and compared. RESULTS: The model incorporating dual-phase CTA data (Model CD) demonstrated superior predictive performance, with higher area under the curve (AUC) values in both training and validation datasets, compared to Models C and CS. Calibration and decision curve analyses further confirmed the enhanced accuracy and clinical utility of Model CD. CONCLUSION: The findings indicate that dual-phase CTA provides a more accurate assessment of collateral circulation compared to single-phase CTA, thereby improving the prediction of PH2 after EVT. This enhanced predictive capability can assist clinicians in making more informed decisions regarding AIS management.

Source: European Journal of Radiology

DOI: 10.1016/j.ejrad.2025.112027