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Whole-brain CT Perfusion at Admission and During Delayed Time-window Detects the Delayed Cerebral Ischemia in Patients with Aneurysmal Subarachnoid Hemorrhage

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Abstract

Objective

To evaluate the utility of computed tomography perfusion (CTP) both at admission and during delayed cerebral ischemia time-window (DCITW) in the detection of delayed cerebral ischemia (DCI) and the change in CTP parameters from admission to DCITW following aneurysmal subarachnoid hemorrhage.

Methods

Eighty patients underwent CTP at admission and during DCITW. The mean and extreme values of all CTP parameters at admission and during DCITW were compared between the DCI group and non-DCI group, and comparisons were also made between admission and DCITW within each group. The qualitative color-coded perfusion maps were recorded. Finally, the relationship between CTP parameters and DCI was assessed by receiver operating characteristic (ROC) analyses.

Results

With the exception of cerebral blood volume (P=0.295, admission; P=0.682, DCITW), there were significant differences in the mean quantitative CTP parameters between DCI and non-DCI patients both at admission and during DCITW. In the DCI group, the extreme parameters were significantly different between admission and DCITW. The DCI group also showed a deteriorative trend in the qualitative color-coded perfusion maps. For the detection of DCI, mean transit time to the center of the impulse response function (Tmax) at admission and mean time to start (TTS) during DCITW had the largest area under curve (AUC), 0.698 and 0.789, respectively.

Conclusion

Whole-brain CTP can predict the occurrence of DCI at admission and diagnose DCI during DCITW. The extreme quantitative parameters and qualitative color-coded perfusion maps can better reflect the perfusion changes of patients with DCI from admission to DCITW.

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Author notes

  1. The authors contributed equally to this study.

Authors and Affiliations

  1. Department of Radiology, the First Affiliated Hospital of Wannan Medical College, Wuhu, 241001, China

    Feng You, Chao Zhang & Yun-feng Zhou

  2. Department of Radiology, Affiliated Hangzhou First People’s Hospital, Hangzhou, 310000, China

    Feng You

  3. Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Wen-juan Tang

  4. School of Medical Information, Wannan Medical College, Wuhu, 241001, China

    Ming-quan Ye

  5. Department of Neurosurgery, the First Affiliated Hospital of Wannan Medical College, Wuhu, 241001, China

    Xing-gen Fang

Authors
  1. Feng You
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  2. Wen-juan Tang
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  3. Chao Zhang
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  4. Ming-quan Ye
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Corresponding author

Correspondence to Yun-feng Zhou.

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Conflict of Interest Statement

The authors declare that there is no conflict of interest with any financial organization or corporation or individual that can inappropriately influence this work.

The study was supported by the National Natural Science Foundation of China, Research on Brain Magnetic Resonance Image Segmentation Based on Particle Computation (No. 61672386).

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You, F., Tang, Wj., Zhang, C. et al. Whole-brain CT Perfusion at Admission and During Delayed Time-window Detects the Delayed Cerebral Ischemia in Patients with Aneurysmal Subarachnoid Hemorrhage. CURR MED SCI 43, 409–416 (2023). https://doi.org/10.1007/s11596-023-2703-z

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  • DOI: https://doi.org/10.1007/s11596-023-2703-z

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