Prolonged Cerebral Circulation Time Is the Best Parameter for Predicting Vasospasm during Initial CT Perfusion in Subarachnoid Hemorrhagic Patients

Autor: Sheng-Che Hung, Yang Shin Shih, Sanford P.C. Hsu, Chung Jung Lin, Chun Fu Lin, Chih-Hsiang Liao, Wei Fa Chu, Yen Tzu Lin, Wan-Yuo Guo
Rok vydání: 2016
Předmět:
Male
Physiology
Cerebral arteries
lcsh:Medicine
Perfusion scanning
Cardiovascular Medicine
Diagnostic Radiology
030218 nuclear medicine & medical imaging
Cerebral circulation
0302 clinical medicine
Blood Flow
Medicine and Health Sciences
Vasospasm
Intracranial
Cardiovascular Imaging
lcsh:Science
Routes of Administration
Cerebral Ischemia
Multidisciplinary
medicine.diagnostic_test
Pharmaceutics
Radiology and Imaging
Angiography
Vasospasm
Arteries
Hematology
Middle Aged
Body Fluids
Blood
Neurology
Cerebrovascular Circulation
Cardiology
Calcium Antagonist Therapy
Female
Radiology
Anatomy
Research Article
Superior sagittal sinus
medicine.medical_specialty
Subarachnoid hemorrhage
Imaging Techniques
Perfusion Imaging
Research and Analysis Methods
03 medical and health sciences
Drug Therapy
Diagnostic Medicine
Intravenous Injections
Internal medicine
medicine
Humans
Pharmacology
business.industry
lcsh:R
Hemodynamics
Biology and Life Sciences
Angiography
Digital Subtraction
Cerebral Arteries
Subarachnoid Hemorrhage
medicine.disease
nervous system diseases
Health Care
SSS
Cardiovascular Anatomy
Blood Vessels
lcsh:Q
Tomography
X-Ray Computed
business
Receptor Antagonist Therapy
030217 neurology & neurosurgery
Zdroj: PLoS ONE
PLoS ONE, Vol 11, Iss 3, p e0151772 (2016)
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0151772
Popis: Purpose We sought to imitate angiographic cerebral circulation time (CCT) and create a similar index from baseline CT perfusion (CTP) to better predict vasospasm in patients with subarachnoid hemorrhage (SAH). Methods Forty-one SAH patients with available DSA and CTP were retrospectively included. The vasospasm group was comprised of patients with deterioration in conscious functioning and newly developed luminal narrowing; remaining cases were classified as the control group. The angiography CCT (XA-CCT) was defined as the difference in TTP (time to peak) between the selected arterial ROIs and the superior sagittal sinus (SSS). Four arterial ROIs were selected to generate four corresponding XA-CCTs: the right and left anterior cerebral arteries (XA-CCTRA2 and XA-CCTLA2) and right- and left-middle cerebral arteries (XA-CCTRM2 and XA-CCTLM2). The CCTs from CTP (CT-CCT) were defined as the differences in TTP from the corresponding arterial ROIs and the SSS. Correlations of the different CCTs were calculated and diagnostic accuracy in predicting vasospasm was evaluated. Results Intra-class correlations ranged from 0.96 to 0.98. The correlations of XA-CCTRA2, XA-CCTRM2, XA-CCTLA2, and XA-CCTLM2 with the corresponding CT-CCTs were 0.64, 0.65, 0.53, and 0.68, respectively. All CCTs were significantly prolonged in the vasospasm group (5.8–6.4 s) except for XA-CCTLA2. CT-CCTA2 of 5.62 was the optimal cut-off value for detecting vasospasm with a sensitivity of 84.2% and specificity 82.4% Conclusion CT-CCTs can be used to interpret cerebral flow without deconvolution algorithms, and outperform both MTT and TTP in predicting vasospasm risk. This finding may help facilitate management of patients with SAH.
Databáze: OpenAIRE
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