Fig 1.
Classification of contrast leakage patterns.
Dual-energy CT images (conventional-like images: a, d, g; arterial phase fusion images: b, e, h; venous phase fusion images: c, f, i) showing three contrast enhancement patterns: Intralesional enhancement without change (a–c), delayed enhancement (d–f), and growing contrast leakage (g–i).
Table 1.
Baseline characteristics.
Fig 2.
Distribution of contrast enhancement pattern by expander and non-expander groups.
The ratio of growing contrast leakage (GL) and delayed enhancement (DE) in the expander group was higher than that in the non-expander group, and there was a statistically significant difference in the distribution between the two groups (Fisher’s exact test, P<0.05). NC, intralesional enhancement without change.
Fig 3.
A 50-year-old male patient visited our emergency department with a headache that occurred 30 min after a slip down before admission. On the initial precontrast brain CT (a), a thin acute subdural hematoma (SDH) was observed in the left frontal convexity (arrows), and an acute subarachnoid hemorrhage (open arrows) was observed along the right frontal cortical sulci. CT angiography was performed because of the possibility of cerebrovascular injury. Growing contrast leakage was observed in the arterial and venous phases of dual-energy CT (b, c, e, f). It was observed on both the fusion (e, f) and conventional-like images (b, c) but was clearly confirmed on the fusion images. On follow-up CT after 5 h (d), the amount of left frontal SDH was significantly increased.
Table 2.
Univariable and multivariable logistic regression analysis for variables associated with hematoma expansion.
Fig 4.
Receiver operating characteristic (ROC) analysis for prediction of hematoma expansion.
Fusion images show a higher area under the curve than conventional-like images (0.71 and 0.61, respectively).
Table 3.
Receiver operating characteristic (ROC) analysis for prediction of hematoma expansion.