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A Volumetric Method for Quantification of Cerebral Vasospasm in a Murine Model of Subarachnoid Hemorrhage
Published on: July 28, 2018
Convenience of the computed tomography perfusion method for cerebral vasospasm detection after subarachnoid
Ryuzaburo Kanazawa1, Mitsuhisa Kato, Kazuya Ishikawa
1Department of Neurosurgery, Kameda Medical Center, Kamogawa, Japan. ryu@nms.ac.jp <ryu@nms.ac.jp>
Insights
Computed tomography perfusion (CTP) offers a convenient method for assessing cerebral vasospasm after subarachnoid hemorrhage (SAH). CTP can identify vasospasm progression, aiding in early diagnosis and patient management.
Area of Science:
- Neuroradiology
- Neurocritical Care
- Medical Imaging
Background:
- Cerebral vasospasm is a common complication following subarachnoid hemorrhage (SAH).
- Existing cerebral perfusion assessment methods like PET, SPECT, xenon CT, and TCD have limitations including patient immobility requirements and operator dependency.
- Computed tomography perfusion (CTP) was investigated for its convenience in assessing SAH-induced cerebral vasospasm.
Observation:
- Nineteen SAH patients (44-85 years) underwent CTP, DSA, and 3D-CTA.
- Mean transit time (MTT), cerebral blood flow (CBF), and cerebral blood volume (CBV) were measured.
- CTP data reliability was confirmed against xenon CT.
Findings:
- An MTT increase >20% indicated vasospasm progression; >47% suggested vasospasm-related infarcts (OR 50).
- Delayed cerebral infarcts correlated with lower CBF and CBV, and higher MTT.
- Significant correlations were found between MTT, CBF, and neurovascular findings.
Implications:
- CTP is a rapid and regular assessment tool for SAH.
- CTP shows potential for identifying cerebral vasospasm post-SAH.
- This technique may improve early detection and management of SAH complications.
Background:
Vasospasm is a frequent complication in the early clinical course after SAH. Although various methods have been used to measure cerebral perfusion including PET, SPECT, xenon CT, and TCD, these require the patients to remain still for a long period. In addition, TCD is operator dependent. The current study aimed to clarify the convenience of CTP for the assessment of cerebral vasospasm caused by SAH.
Methods:
Nineteen patients with SAH aged 44 to 85 years (mean, 64 years) were recruited with informed consent. All patients were treated with the prevailing therapy and underwent CTP on days 6 to 9, followed by DSA and 3D-CTA to detect cerebral vasospasm. In each patient, we measured the MTT, CBF, and CBV. The reliability of CTP data was verified by comparing the data from CTP and xenon CT between the controls, and the average was calculated. Six ROIs were located symmetrically in the frontal, temporal, and occipital lobes.
Results:
An MTT value more than 20% greater than the average indicated the progression of cerebral vasospasm, and patients with vasospasm-related infarcts exhibited an MTT more than 47% greater than the mean value (odds ratio, 50). Patients with delayed cerebral infarcts had a significantly lower mean CBF and CBV and higher MTT than patients who did not develop CI.
Conclusion:
Significant correlations between MTT and CBF values and neurovascular findings were obtained. Computed tomography perfusion can be performed in a short time and on a regular basis, and it therefore has the potential to identify cerebral vasospasm because of SAH.
