|
|
Predictive value of multi-mode CT scan in delayed cerebral infarction after spontaneous subarachnoid hemorrhage |
1.Department of Radiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325015; 2.Department of Chemoradiation Oncology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325015
|
|
Cite this article: |
DUAN Yuxia1,CHEN Weijian1,GUO Xianzhong1, et al. Predictive value of multi-mode CT scan in delayed cerebral infarction after spontaneous subarachnoid hemorrhage[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2015, 45(12): 879-.
|
|
Abstract Objective: To investigate the value of Multi-mode CT scan in predicting delayed cerebral infarction (DCI) after spontaneous subarachnoid hemorrhage (SSAH). Methods: Eighty-two patients were scanned with head Multi-mode CT in 72 hours after SSAH attacking, including plain CT scan, computer tomography angiography (CTA) scan and computer tomography perfusion (CTP) scan. All of the 82 patients received plain CT scan again in 14 days. A total of 82 patients were classified into two groups: DCI group (n=30) and NDCI group (n=52). Results: After quantitative comparison of CTP of both groups, the average rCBF was 0.82 and 1.02 (P<0.01), the average rCBV was 0.90 and 1.03 (P<0.01), and the average rMTT was 1.24 and 0.97 (P<0.01). Brain hemodynamics began to change in early days in SAH patients. The sensitivity, specificity, false negative rates and false positive rates of CTP and CTA’s value in predicting DCI were 100.0%, 42.3%, 0, 57.7% and 20.0%, 88.5%, 80.0%, 11.5%, respectively. All of these were calculated at the base of plain CT scan. Conclusion: Brain CTA combined with CTP will be helpful for clinician to comprehend the shape of cerebral vessel and the perfusion of brain tissue in patients with SAH. The brain blood flow changes can be known quantitatively. Also it is meaningful in early predicating DCI and its range, and guiding the early intervention of the DCI.
|
Received: 22 October 2014
|
|
|
|
|
[1] Ghandehari K, Ahmadi F, Afzalnia A. Results of surgical and nonsurgical treatment of aneurysms in a developing country[J]. Stroke Res Treat, 2011: 560831.
[2] Robbert M, Hoogmoed J, van Straaten HA, et al. Time intervals from aneurysmal subarachnoid hemorrhage to treatment and factors contributing to delay[J]. J Neurol, 2014, 261(3): 473-479.
[3] Wintermark M, Flanders AE, Velthuis B, et al. Perfusion-CT assessment of infarct core and penumbra: receiver operating characteristic curve analysis in 130 patients suspected of acute hemispheric stroke[J]. Stroke, 2006, 37(4): 979-985.
[4] Suzuki Y, Nakajima M, Ikeda H, et al. Evaluation of hyperacute stroke using perfusion computed tomography[J]. Neurol Med Chir (Tokyo), 2005, 45(7): 333-343.
[5] 高培毅, 林燕. 脑梗死前期脑局部低灌注的CT灌注成像表现及分期[J]. 中华放射学杂志, 2003, 37(10): 882-886.
[6] Nabavi DG, LeBlanc LM, Baxter B, et al. Monitoring cerebral perfusion after subarachnoid hemorrhage using CT[J].Neuroradiology, 2001, 43(1): 7-16.
[7] Pina C, Austin J, Rachel G, et al. Using CT perfusion during the early baseline period in aneurysmal subarachnoid hemorrhage to assess for development of vasospasm[J]. Neuroradiology, 2011, 53(6): 425-434.
[8] 汤深, 李惠民, 于红, 等. 血管造影在诊断颅脑外伤患者脑血管痉挛中的应用[J]. 中华创伤杂志, 2006, 19(10): 623-624.
[9] Mark R, Harragan. Computed tomographic perfusion in the management of aneurysmal subarachnoid hemorrhage: new application of an existent technique[J]. Neurosurgery, 2005, 56(2): 304-317.
[10] 李珉, 胡颖红, 陈高. 动脉瘤性蛛网膜下腔出血后脑血管痉挛与延迟性缺血性神经功能障碍的相关性[J]. 浙江大学学报(医学版), 2006, 35(2): 215-218.
[11] Elke H, Stella B, Edgar D, et al. Perfusion-weighted MRI to evaluate cerebral auto-regulation in aneurysmal subarachnoid hemorrhage[J]. Neuroradiology, 2008, 50(11): 929-938.
[12] Turowski B, du Mesnil de Rochemont B, Beck J, et al. Assessment of changes in cerebral circulation time due to vasospasm in a specific arterial territory: effect of angioplasty[J]. Neuroradiology, 2005, 47(2): 134-143.
[13] Jaeger M, Schumann MU, Soehle M, et al. Hemorrhage by brain tissue oxygen pressure reactivity and its relation to delayed continuous monitoring of cerebrovascular autoregulation after subarachnoid hemorrhage[J]. Stroke, 2007, 38(3): 981-986.
|
|
|
|