title: Long-term impact of perfusion CT data after subarachnoid hemorrhage.
abstract: BACKGROUND
  Dynamic perfusion computed tomography (PCT) has been established as a diagnostic instrument for the detection of vasospasm after subarachnoid hemorrhage (SAH). The purpose of this study was to assess the prognostic impact of PCT parameters after SAH on the long-term outcome of patients.
  
  
  METHODS
  Three hundred twelve patients were retrospectively interrogated with a questionnaire 23.06 ± 14.33 months after spontaneous subarachnoid hemorrhage. The modified Rankin scale (mRS) was determined, respectively. Scheduled PCT data sets from the first days after ictus were available for all patients.
  
  
  RESULTS
  The maximum mean transit time over several examinations per hemisphere (MTTPEAK) values were significantly correlated (p ≤ 0.001, r = 0.422) with the clinical long-term outcome (mRS). Corresponding to our linear regression analysis, MTTPEAK is the second most important regressor (behind clinical severity of the initial hemorrhage) for the prediction of long-term mRS. An MTTPEAK threshold of 3.98 s (identified by receiver operating characteristic analysis, area under the curve = 0.75) predicted an unfavorable long-term outcome (mRS ≥ 2) with a sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of 67.3, 74.3, 84.5, 52.1, and 69.6 %, respectively.
  
  
  CONCLUSIONS
  The presented data corroborate the relevance of PCT data for the clinical long-term outcome of SAH patients. By identification of patients who are at risk for a bad outcome and may need escalation of therapy, risk-benefit analysis is supported.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, Moorenstr. 5, 40225, Düsseldorf, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Mathys
authors.forename: Daniel
authors.initials: D
authors.lastname: Martens
authors.forename: Dorothea C
authors.initials: DC
authors.lastname: Reichelt
authors.forename: Julian
authors.initials: J
authors.lastname: Caspers
authors.forename: Joel
authors.initials: J
authors.lastname: Aissa
authors.forename: Rebecca
authors.initials: R
authors.lastname: May
authors.forename: Daniel
authors.initials: D
authors.lastname: Hänggi
authors.forename: Gerald
authors.initials: G
authors.lastname: Antoch
authors.forename: Bernd
authors.initials: B
authors.lastname: Turowski
mesh_terms: D005260:Female; D005858:Germany; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging / Q000379:methods* / Q000706:statistics & numerical data*; D015995:Prevalence; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging* / Q000628:therapy; D014057:Tomography, X-Ray Computed / Q000379:methods* / Q000706:statistics & numerical data*; D016896:Treatment Outcome
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