| Objective: To investigate the value of one-stop whole-brain CT perfusion(CTP)on admission to predict cerebral vasospasm(CVS)after aneurysmal subarachnoid hemorrhage(aSAH).Methods: 83 patients with aSAH underwent one-stop whole-brain CTP examination,including non-contrast computed tomography(NCCT),CTP,and computed tomography angiography(CTA)images derived from CTP data.Retrospective analysis of the basic data of patients at admission: age,gender,Hunt-Hess classification,Glasgow coma score(GCS),Fisher score and qualitative,quantitative CTP parameters.The patients were divided into CVS group and non-CVS group according to CTA manifestations,and the relationship between qualitative and quantitative CTP parameters and CVS on admission was evaluated.At the same time,Logistic regression analysis was performed on factors that may affect CVS.The correlation between CVS and delayed cerebral ischemia(DCI)was evaluated in aSAH patients.Results: 26 of 83(33.7%)aASH patients developed CVS.The qualitative and quantitative CTP parameters on admission: Cerebral Blood Volume(CBF),Mean Transit Time(MTT),Time To Drain(TTD),Time To Start(TTS),Transit time to the center of the Impulse Response Function(Tmax),minimum CBF,maximum MTT,and maximum TTD were statistically significant differences between the CVS and non-CVS groups(P <0.05).Age,hydrocephalus,Fisher score ? Grade III,GCS,and maximum MTT parameters were all independent risk factors for CVS in aSAH patients(P <0.05).The occurrence of CVS and DCI was related in aSAH patients(P = 0.022).Conclusions: 1.The qualitative and quantitative parameters of one-stop whole-brain CTP at admission can predict the occurrence of CVS in aSAH patients.2.Patients with younger age,hydrocephalus,Fisher score ? Grade III,lower GCS,and prolonged maximum MTT parameters may be more likely to develop CVS.3.The occurrence of CVS and DCI was related in aSAH patients.Purpose: To explore the value of whole-brain CTP at admission(<24h)and DCI time-window(4-14 days)for evaluation DCI in the a SAH patients.Methods:80 a SAH patients underwent one-stop whole-brain CTP scan at admission and DCI time-window.The mean and extreme values of 12 quantitative CTP parameters were measured.CTP parameters at admission and DCI time-window were compared between DCI and non-DCI group,and between admission and DCITW in the DCI group.The relationship of CTP parameters with DCI was assessed by logistic regression.Optimal threshold values of the ROC curve were derived to calculate the sensitivities and specificities of CTP parameters.Results: 53 of 80(53/88,60.2%)patients developed DCI.Except for CBV,the quantitative CTP parameters: CBF,MTT,TTS,TTD and Tmax,at admission and DCI time window were significantly different(P <0.05)between DCI and non-DCI patients.The DCI group quantitative CTP parameters were further extended compared with the non-DCI group.There were no differences in mean CTP parameters between admission and DCI time windows in DCI patients(P> 0.05);however,there were statistical differences in extreme values(P <0.05).Qualitative CTP in DCI and on-DCI groups was statistically significant.At the same time,the change trend of qualitative parameters was deteriorating in the DCI group.Among the quantitative CTP parameters,the Tmax at admission and the TTS within the time window had areas under the curve(AUC)of 0.698 and 0.789,respectively,and the optimal thresholds were 2.220 s and 0.605 s,respectively.The combined model(Tmax at admission / TTS within time window)has higher detection value(AUC of 0.817,sensitivity of 60.56%,specificity of 70.73%)Conclusions: 1.One-stop whole-brain CTP examination can not only evaluate the morphological information of cerebral arteries in a SAH patients,but also evaluate the functional information of cerebral blood flow perfusion.2.Whole-brain CTP can predict the occurrence of DCI on admission and diagnose DCI within the time window of DCI.3.Combined the CTP parameters at admission and DCI time-window can further improve the efficiency of detecting DCI in a SAH patients. |
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