Convenience of the computed tomography perfusion method for cerebral vasospasm detection after subarachnoid hemorrhage

Kanazawa, Ryuzaburo; Kato, Mitsuhisa; Ishikawa, Kazuya; Eguchi, Tsuneyoshi; Teramoto, Akira

doi:10.1016/j.surneu.2006.09.026

Cited by 31 publications

(21 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…1) This finding may also be useful in the acute phase of cerebral infarction. 19,24,27,29) This is in agreement with the changes in CBF and MTT observed during delayed CVS, 12,25,28) which are considered to suggest cerebral circulatory disturbance. Also, a threshold MTT value for diagnosing CVS has been reported, but it varies depending on the perfusion CT protocol, software, and hardware used at individual centers.…”

Section: Discussionsupporting

confidence: 70%

“…6,11,20) Recently, computed tomography (CT) perfusion imaging has been used to assess patients with delayed CVS. 12,25,28) A number of hemodynamic parameters are available for CT perfusion imaging. One such parameter, the mean transit time (MTT), is defined as the mean time required for blood to perfuse through a region of tissue, and is highly sensitive to hemodynamic disturbances.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Early Cerebral Circulatory Disturbance in Patients Suffering Subarachnoid Hemorrhage Prior to the Delayed Cerebral Vasospasm Stage: Xenon Computed Tomography and Perfusion Computed Tomography Study

Honda

Sase

Yokota

et al. 2012

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

Subarachnoid hemorrhage (SAH) causes dynamic changes in cerebral blood flow (CBF), and results in delayed ischemia due to vasospasm, and early perfusion deficits before delayed cerebral vasospasm (CVS). The present study examined the severity of cerebral circulatory disturbance during the early phase before delayed CVS and whether it can be used to predict patient outcome. A total of 94 patients with SAH underwent simultaneous xenon computed tomography (CT) and perfusion CT to evaluate cerebral circulation on Days 1-3. Cerebral blood flow (CBF) was measured using xenon CT and the mean transit time (MTT) using perfusion CT and calculated cerebral blood volume (CBV). Outcome was evaluated with the Glasgow Outcome Scale (good recovery [GR] ). Hunt and Hess (HH) grade II patients displayed significantly higher CBF and lower MTT than HH grade IV and V patients. HH grade III patients displayed significantly higher CBF and lower MTT than HH grade IV and V patients. Patients with favorable outcome (GR or MD) had significantly higher CBF and lower MTT than those with unfavorable outcome (SD, VS, or D). Discriminant analysis of these parameters could predict patient outcome with a probability of 74.5%. Higher HH grade on admission was associated with decreased CBF and CBV and prolonged MTT. CBF reduction and MTT prolongation before the onset of delayed CVS might influence the clinical outcome of SAH. These parameters are helpful for evaluating the severity of SAH and predicting the outcomes of SAH patients.

show abstract

Section: Discussionsupporting

confidence: 70%

mentioning

confidence: 99%

Early Cerebral Circulatory Disturbance in Patients Suffering Subarachnoid Hemorrhage Prior to the Delayed Cerebral Vasospasm Stage: Xenon Computed Tomography and Perfusion Computed Tomography Study

Honda

Sase

Yokota

et al. 2012

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

show abstract

“…As relevant studies for this analysis, 6 articles underwent full-text search and assessment, and only one article met the inclusion criteria. Three articles were excluded because the reported data could not construct the fourfold tables (6,12,16). Two articles were not included because one was a reduplicated study (8) and one was a conference abstract.…”

Section: Trial Selectionmentioning

confidence: 99%

Evaluating the diagnostic accuracy of CT perfusion in patients with cerebral vasospasm after aneurysm rupture: a meta-analysis

Sun¹,

Zhang²,

Ma³

et al. 2014

Turkish Neurosurgery

View full text Add to dashboard Cite

AIm: Computed tomography perfusion (CTP) has recently been used to identify regions of potential ischemia due to cerebral vasospasm, and CTP parameters are able to quantitatively evaluate brain parenchymal perfusion. We performed a meta-analysis as an update of a previous paper published in 2010 and aimed at evaluating the diagnostic accuracy of CTP and CTP parameters for vasospasm after aneurysm rupture. mATERIAL and mETHods: Relevant articles published between January 2005 and May 2013 were systematically searched for analysis without language restrictions from the PubMed/MEDLINE, Embase, and Cochrane databases. The data of CTP parameters, including CBV, CBF, MTT and TTP, were extracted for analysis, and the pooled sensitivity, specificity, PLR, NLR, DOR and the sROC curve were determined. REsuLTs:Three relevant articles and a total of 98 patients were finally involved in the analysis. The pooled sensitivity, specificity, PLR, NLR, DOR, and AUC of CTP for diagnosing cerebral vasospasm were 94%, 90%, 8.22, 0.06, 141.09, and 0.9802, respectively. Through the evaluation of CTP parameters, MTT had a higher sensitivity (91%) while CBF had a higher specificity (93%). CoNCLusIoN:CT perfusion has a great diagnostic value to detect cerebral vasospasm compared with DSA in patients with aneurysmal subarachnoid hemorrhage (aSAH). As CTP parameters, CBF and MTT quantitatively evaluate brain parenchymal perfusion. soNuÇ: BTP testinin anevrizmal subaraknoid hemorajili (aSAK) hastalarda serebral vazospazmı belirlemede anjiyografiye kıyasla önemli diyagnostik değeri vardır. BTP parametreleri olan CBF ve MTT beyin parankimi perfüzyonunu kantitatif olarak değerlendirirler.ANAHTAR sÖZCÜKLER: BTP, BT perfüzyon, BTP parametreleri, Vazospazm, Serebral vazospazm ABBREVIATIoNs: CTP: computed tomography perfusion, CBV: cerebral blood volume, CBF: cerebral blood flow, mTT: mean transit time, TTP: time to peak, PLR: positive likelihood ratio, NLR: negative likelihood ratio, doR: diagnostic odds ratio, CIs: confidence intervals, sRoC: summary receiver-operating characteristic, dsA: digital substraction angiography, asAH: aneurysmal subarachnoid hemorrhage.

show abstract

“…These findings are in agreement with clinical studies that have demonstrated the ability of CT perfusion to detect delayed vasospasm after SAH. 10,26,27 Wintermark et al 10 showed that MTT was the perfusion parameter that best iden- Basilar artery diameter (mean Ϯ SD) before SAH (baseline) and after SAH for animals with mild and moderatesevere VSPdelayed. In the mild VSPdelayed group, arterial diameter was significantly less than baseline on days 2 and 4 (number sign, P Ͻ .01 compared with baseline).…”

Section: Severity Ofmentioning

confidence: 99%

“…12,28,29 Prolonged MTT may also indicate cerebral infarction resulting from delayed vasospasm after SAH. 27 Regions of increased MTT are correlated with delayed vasospasm, suggesting that MTT is a potentially useful diagnostic marker of delayed vasospasm. We expanded on these results by investigating the temporal relationship of MTT subsequent to SAH.…”

Section: Figmentioning

confidence: 99%

CT Perfusion-Derived Mean Transit Time Predicts Early Mortality and Delayed Vasospasm after Experimental Subarachnoid Hemorrhage

Laslo

Eastwood²,

Pakkiri³

et al. 2007

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

show abstract

Convenience of the computed tomography perfusion method for cerebral vasospasm detection after subarachnoid hemorrhage

Cited by 31 publications

References 25 publications

Early Cerebral Circulatory Disturbance in Patients Suffering Subarachnoid Hemorrhage Prior to the Delayed Cerebral Vasospasm Stage: Xenon Computed Tomography and Perfusion Computed Tomography Study

Early Cerebral Circulatory Disturbance in Patients Suffering Subarachnoid Hemorrhage Prior to the Delayed Cerebral Vasospasm Stage: Xenon Computed Tomography and Perfusion Computed Tomography Study

Evaluating the diagnostic accuracy of CT perfusion in patients with cerebral vasospasm after aneurysm rupture: a meta-analysis

CT Perfusion-Derived Mean Transit Time Predicts Early Mortality and Delayed Vasospasm after Experimental Subarachnoid Hemorrhage

Contact Info

Product

Resources

About