Photon counting CT vs. flat-panel CT in the evaluation of enhancement patterns in chronic subdural hematoma after middle meningeal artery embolization
IntroductionMiddle 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...
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| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-05-01
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| Series: | Frontiers in Neurology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1608308/full |
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| Summary: | IntroductionMiddle 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.MethodsWe 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.ResultsPCCT 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.DiscussionPCCT 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. |
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| ISSN: | 1664-2295 |