Hospital: H U C A.
Ciudad:
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Aut@r o Autores: C. Suárez-Arcay, N. Sordo-Alonso, H. Cigarrán-Sexto, A. Barrio-Alonso, D. GarcíaPerez, F. García-Arias.,
Presentación:
24 Year old woman with BRAF mutation and diagnosed of melanoma in 2014. She underwent surgery and was treated with Drabafenib and trametinib. In April 2016 she consulted the Emergency Department with headache, vomiting and right leg hypoesthesia. We performed a brain CT that showed multiple spontaneously hyperdense lesions in both cerebral hemispheres and a heterogeneous lesion in right basal ganglia. Contrast enhanced Dual Energy CT (DECT) was performed. The iodine map showed that the heterogeneous lesion in right basal ganglia was a solid lesion with enhancement and haemorrhagic focus. The rest of lesions showed contrast enhancement. These findings are suggestive of multiple brain metastasis from melanoma, one of them partially haemorrhagic.
Discusión:
DECT allows differentiating intracranial haemorrhage from iodinated contrast material enhancement or contrast leak with high sensitivity and specificity. The use of DECT has been demonstrated to detect underlying tumors in case of acute intracranial haemorrhage in comparison to conventional CT with high accuracy. DECT has also the advantage of less radiation dose to the patient without compromise image quality.
Conclusión:
DECT allows differentiating intracranial haemorrhage from iodinated contrast material enhancement or contrast leak with high sensitivity and specificity. The use of DECT has been demonstrated to detect underlying tumors in case of acute intracranial haemorrhage in comparison to conventional CT with high accuracy. DECT has also the advantage of less radiation dose to the patient without compromise image quality.
Bibliografía:
– Phan CM, Yoo AJ, Hirsch JA, Nogueira RG, Gupta R. Differentiation of hemorrhage from iodinated contrast in different intracranial compartments using dual-energy head CT. AJNR Am J Neuroradiol. 2012,33(6):1088-94 – Gupta R, Phan CM, Leidecker C, Brady T