Value Of CT Perfusion Imaging In Predicting Delayed Cerebral Ischemia After Subarachnoid Hemorrhage Without Cerebral Vasospasm

Objective:Preliminary study of CT perfusion imaging in predicting delayed cerebral ischemia after subarachnoid hemorrhage without cerebral vasospasmMethods:Retrospective analysis of our hospital from August 2017 to July 2018 treated patients with subarachnoid hemorrhage,TCD(Transcranial Doppler ultrasound)and CTP examination were performed on the day of onset and 4-7 days after onset day.Choose these two TCD examinations showed negative CVS patients,and follow-up of these patients within a week after the second CTP examination whether DCI occurred,the subjects were divided into DCI group and non DCI group,and there were 15 cases in each group.Then quantitative parameters of CT perfusion imaging on the day of onset and 4-7 days after onset were measured,the region of interest was selected by consensus among two senior doctors,each quantitative parameter was measured three times and averaged them.CTP quantitative parameters include Time to peak(TTP),Mean transit time(MTT),Cerebral blood flow(CBF),Cerebral blood volume(CBV),Those who accorded with normal distribution,using independent sample t test to compare the differences of CTP quantitative parameters between two groups on the day of onset and 4-7 days after onset.,and used the ROC curve to acquaintance the predictive value of each parameter to DCI,and to find the best threshold for each parameter to predict DCI.Results:There was only a slight difference in TTP between DCI group and NON-DCI group on the day of onset of SAH,that is,the TTP value of DCI group was slightly longer than that of NON-DCI group(p<0.05),but there was no significant difference in MTT,CBF and CBV between groups(p>0.05);CTP perfusion parameters of DCI group and NON-DCI group were significantly different between 4-7 days after onset of SAH(p<0.05).Compared with NON-DCI group,TTP and MTT values in DCI group were prolonged,while CBF and CBV values were decreased.CBF,a CTP parameter,had relatively higher specificity and sensitivity in predicting the occurrence of DCI after SAH.Conclusion:? On the day of SAH onset,the parameters of CTP examination predicted that the DCI effect was not good;?CTP examination predicts high value of DCI research on the 4-7 days after onset of SAH;?The quantitative parameter CBF in CTP has relatively higher sensitivity and specificity for predicting DCI after SAH.