CT perfusion diagnoses delayed cerebral ischemia in the early stage of the time-window after aneurysmal subarachnoid hemorrhage - 16/09/17
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Abstract |
Background and purpose |
It has been acknowledged that delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (SAH) can be diagnosed by CT perfusion (CTP) in the DCI time-window. We evaluated the diagnostic accuracy of CTP for DCI during the early stage of the time-window.
Materials and methods |
We prospectively enrolled patients with aneurysmal SAH. DCI was defined as both new cerebral infarction and clinical deterioration after SAH. CTP was performed by using a standardized protocol with predefined regions of interest in 4 to 6 days after SAH. We quantitatively evaluated the diagnostic accuracy of eight CTP parameters (4 for absolute parameters and 4 for relative parameters). The receiver operator characteristic (ROC) curves of all parameters were generated and the optimal threshold values were derived for the calculation of sensitivities and specificities.
Results |
Fifty-three patients were enrolled and 20 patients were diagnosed with DCI. In the analysis of absolute CTP parameters, CBF and MTT had areas under the curve (AUC) >0.75 and the optimal threshold value was 40.4mL/100g/min and 3.78seconds, respectively. Through the evaluation of relative CTP parameters, all 4 parameters had AUC >0.75 and the optimal threshold value was 0.9 for CBV ratio, 0.85 for CBF ratio, 0.32seconds for MTT difference and 1.31seconds for TTP difference.
Conclusions |
Besides two absolute CTP parameters (CBV and TTP), all six CTP parameters can be used as good diagnostic tests for DCI in the early stage of the time-window.
Le texte complet de cet article est disponible en PDF.Keywords : CT perfusion, Delayed cerebral ischemia, Subarachnoid hemorrhage, Diagnostic threshold values
Plan
Vol 44 - N° 5
P. 313-318 - septembre 2017 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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