Cargando…
Prolonged Cerebral Circulation Time Is the Best Parameter for Predicting Vasospasm during Initial CT Perfusion in Subarachnoid Hemorrhagic Patients
PURPOSE: We sought to imitate angiographic cerebral circulation time (CCT) and create a similar index from baseline CT perfusion (CTP) to better predict vasospasm in patients with subarachnoid hemorrhage (SAH). METHODS: Forty-one SAH patients with available DSA and CTP were retrospectively included....
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4795708/ https://www.ncbi.nlm.nih.gov/pubmed/26986626 http://dx.doi.org/10.1371/journal.pone.0151772 |
_version_ | 1782421648795762688 |
---|---|
author | Lin, Chun Fu Hsu, Sanford P. C. Lin, Chung Jung Guo, Wan Yuo Liao, Chih Hsiang Chu, Wei Fa Hung, Sheng Che Shih, Yang Shin Lin, Yen Tzu |
author_facet | Lin, Chun Fu Hsu, Sanford P. C. Lin, Chung Jung Guo, Wan Yuo Liao, Chih Hsiang Chu, Wei Fa Hung, Sheng Che Shih, Yang Shin Lin, Yen Tzu |
author_sort | Lin, Chun Fu |
collection | PubMed |
description | PURPOSE: We sought to imitate angiographic cerebral circulation time (CCT) and create a similar index from baseline CT perfusion (CTP) to better predict vasospasm in patients with subarachnoid hemorrhage (SAH). METHODS: Forty-one SAH patients with available DSA and CTP were retrospectively included. The vasospasm group was comprised of patients with deterioration in conscious functioning and newly developed luminal narrowing; remaining cases were classified as the control group. The angiography CCT (XA-CCT) was defined as the difference in TTP (time to peak) between the selected arterial ROIs and the superior sagittal sinus (SSS). Four arterial ROIs were selected to generate four corresponding XA-CCTs: the right and left anterior cerebral arteries (XA-CCT(RA2) and XA-CCT(LA2)) and right- and left-middle cerebral arteries (XA-CCT(RM2) and XA-CCT(LM2)). The CCTs from CTP (CT-CCT) were defined as the differences in TTP from the corresponding arterial ROIs and the SSS. Correlations of the different CCTs were calculated and diagnostic accuracy in predicting vasospasm was evaluated. RESULTS: Intra-class correlations ranged from 0.96 to 0.98. The correlations of XA-CCT(RA2,) XA-CCT(RM2,) XA-CCT(LA2,) and XA-CCT(LM2) with the corresponding CT-CCTs were 0.64, 0.65, 0.53, and 0.68, respectively. All CCTs were significantly prolonged in the vasospasm group (5.8–6.4 s) except for XA-CCT(LA2.) CT-CCT(A2) of 5.62 was the optimal cut-off value for detecting vasospasm with a sensitivity of 84.2% and specificity 82.4% CONCLUSION: CT-CCTs can be used to interpret cerebral flow without deconvolution algorithms, and outperform both MTT and TTP in predicting vasospasm risk. This finding may help facilitate management of patients with SAH. |
format | Online Article Text |
id | pubmed-4795708 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-47957082016-03-23 Prolonged Cerebral Circulation Time Is the Best Parameter for Predicting Vasospasm during Initial CT Perfusion in Subarachnoid Hemorrhagic Patients Lin, Chun Fu Hsu, Sanford P. C. Lin, Chung Jung Guo, Wan Yuo Liao, Chih Hsiang Chu, Wei Fa Hung, Sheng Che Shih, Yang Shin Lin, Yen Tzu PLoS One Research Article PURPOSE: We sought to imitate angiographic cerebral circulation time (CCT) and create a similar index from baseline CT perfusion (CTP) to better predict vasospasm in patients with subarachnoid hemorrhage (SAH). METHODS: Forty-one SAH patients with available DSA and CTP were retrospectively included. The vasospasm group was comprised of patients with deterioration in conscious functioning and newly developed luminal narrowing; remaining cases were classified as the control group. The angiography CCT (XA-CCT) was defined as the difference in TTP (time to peak) between the selected arterial ROIs and the superior sagittal sinus (SSS). Four arterial ROIs were selected to generate four corresponding XA-CCTs: the right and left anterior cerebral arteries (XA-CCT(RA2) and XA-CCT(LA2)) and right- and left-middle cerebral arteries (XA-CCT(RM2) and XA-CCT(LM2)). The CCTs from CTP (CT-CCT) were defined as the differences in TTP from the corresponding arterial ROIs and the SSS. Correlations of the different CCTs were calculated and diagnostic accuracy in predicting vasospasm was evaluated. RESULTS: Intra-class correlations ranged from 0.96 to 0.98. The correlations of XA-CCT(RA2,) XA-CCT(RM2,) XA-CCT(LA2,) and XA-CCT(LM2) with the corresponding CT-CCTs were 0.64, 0.65, 0.53, and 0.68, respectively. All CCTs were significantly prolonged in the vasospasm group (5.8–6.4 s) except for XA-CCT(LA2.) CT-CCT(A2) of 5.62 was the optimal cut-off value for detecting vasospasm with a sensitivity of 84.2% and specificity 82.4% CONCLUSION: CT-CCTs can be used to interpret cerebral flow without deconvolution algorithms, and outperform both MTT and TTP in predicting vasospasm risk. This finding may help facilitate management of patients with SAH. Public Library of Science 2016-03-17 /pmc/articles/PMC4795708/ /pubmed/26986626 http://dx.doi.org/10.1371/journal.pone.0151772 Text en © 2016 Lin et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Lin, Chun Fu Hsu, Sanford P. C. Lin, Chung Jung Guo, Wan Yuo Liao, Chih Hsiang Chu, Wei Fa Hung, Sheng Che Shih, Yang Shin Lin, Yen Tzu Prolonged Cerebral Circulation Time Is the Best Parameter for Predicting Vasospasm during Initial CT Perfusion in Subarachnoid Hemorrhagic Patients |
title | Prolonged Cerebral Circulation Time Is the Best Parameter for Predicting Vasospasm during Initial CT Perfusion in Subarachnoid Hemorrhagic Patients |
title_full | Prolonged Cerebral Circulation Time Is the Best Parameter for Predicting Vasospasm during Initial CT Perfusion in Subarachnoid Hemorrhagic Patients |
title_fullStr | Prolonged Cerebral Circulation Time Is the Best Parameter for Predicting Vasospasm during Initial CT Perfusion in Subarachnoid Hemorrhagic Patients |
title_full_unstemmed | Prolonged Cerebral Circulation Time Is the Best Parameter for Predicting Vasospasm during Initial CT Perfusion in Subarachnoid Hemorrhagic Patients |
title_short | Prolonged Cerebral Circulation Time Is the Best Parameter for Predicting Vasospasm during Initial CT Perfusion in Subarachnoid Hemorrhagic Patients |
title_sort | prolonged cerebral circulation time is the best parameter for predicting vasospasm during initial ct perfusion in subarachnoid hemorrhagic patients |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4795708/ https://www.ncbi.nlm.nih.gov/pubmed/26986626 http://dx.doi.org/10.1371/journal.pone.0151772 |
work_keys_str_mv | AT linchunfu prolongedcerebralcirculationtimeisthebestparameterforpredictingvasospasmduringinitialctperfusioninsubarachnoidhemorrhagicpatients AT hsusanfordpc prolongedcerebralcirculationtimeisthebestparameterforpredictingvasospasmduringinitialctperfusioninsubarachnoidhemorrhagicpatients AT linchungjung prolongedcerebralcirculationtimeisthebestparameterforpredictingvasospasmduringinitialctperfusioninsubarachnoidhemorrhagicpatients AT guowanyuo prolongedcerebralcirculationtimeisthebestparameterforpredictingvasospasmduringinitialctperfusioninsubarachnoidhemorrhagicpatients AT liaochihhsiang prolongedcerebralcirculationtimeisthebestparameterforpredictingvasospasmduringinitialctperfusioninsubarachnoidhemorrhagicpatients AT chuweifa prolongedcerebralcirculationtimeisthebestparameterforpredictingvasospasmduringinitialctperfusioninsubarachnoidhemorrhagicpatients AT hungshengche prolongedcerebralcirculationtimeisthebestparameterforpredictingvasospasmduringinitialctperfusioninsubarachnoidhemorrhagicpatients AT shihyangshin prolongedcerebralcirculationtimeisthebestparameterforpredictingvasospasmduringinitialctperfusioninsubarachnoidhemorrhagicpatients AT linyentzu prolongedcerebralcirculationtimeisthebestparameterforpredictingvasospasmduringinitialctperfusioninsubarachnoidhemorrhagicpatients |