title: Early quantitative CT perfusion parameters variation for prediction of delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage.
abstract: OBJECTIVE
  To prospectively evaluate the predictive value of cerebral perfusion-computerized tomography (CTP) parameters variation between day0 and day4 after aneurysmal subarachnoid haemorrhage (aSAH).
  
  
  METHODS
  Mean transit time (MTT) and cerebral blood flow (CBF) values were compared between patients with delayed cerebral ischemia (DCI+ group) and patients without DCI (DCI- group) for previously published optimal cutoff values and for variations of MTT (ΔMTT) and of CBF (ΔCBF) values between day0 and day4. DCI+ was defined as a cerebral infarction on 3-months follow-up MRI.
  
  
  RESULTS
  Among 47 included patients, 10 suffered DCI+. Published optimal cutoff values did not predict DCI, either at day0 or at day4. Conversely, ΔMTT and ΔCBF significantly differed between the DCI+ and DCI- groups, with optimal ΔMTT and ΔCBF values of 0.91 seconds (83.9 % sensitivity, 79.5 % specificity, AUC 0.84) and -7.6 mL/100 g/min (100 % sensitivity, 71.4 % specificity, AUC 0.86), respectively. In multivariate analysis, ΔCBF (OR = 1.91, IC95% 1.13-3.23 per each 20 % decrease of ΔCBF) and ΔMTT values (OR = 14.70, IC95% 4.85-44.52 per each 20 % increase of ΔMTT) were independent predictors of DCI.
  
  
  CONCLUSIONS
  Assessment of MTT and CBF value variations between day0 and day4 may serve as an early imaging surrogate for prediction of DCI in aSAH.
  
  
  CONCLUSIONS
  • CT perfusion values are an imaging surrogate for prediction of DCI. • Early variations (day0-day4) after aneurysmal subarachnoid haemorrhage predicted DCI. • A CBF decrease of 7.6 mL/min/100 g predicted DCI with 100 % sensitivity. • An MTT increase of 0.91 seconds predicted DCI with 83.9 % sensitivity. • DCI risk multiplied by 2 per 20 % ΔCBF decrease and by 15 per 20 % ΔMTT increase.
authors.affiliation: Departments of Neuroradiology, Centre Hospitalier Sainte-Anne, Université Paris Descartes, Sorbonne Paris Cité, INSERM UMR894, 1 rue Cabanis, 75014, Paris, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Rodriguez-Régent
authors.affiliation: Departments of Neuroradiology, Centre Hospitalier Sainte-Anne, Université Paris Descartes, Sorbonne Paris Cité, INSERM UMR894, 1 rue Cabanis, 75014, Paris, France.
authors.forename: Monia
authors.initials: M
authors.lastname: Hafsa
authors.affiliation: Department of Neurology, Centre Hospitalier Sainte-Anne, Université Paris-Descartes, INSERM U894, Paris, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Turc
authors.affiliation: Departments of Neuroradiology, Centre Hospitalier Sainte-Anne, Université Paris Descartes, Sorbonne Paris Cité, INSERM UMR894, 1 rue Cabanis, 75014, Paris, France.
authors.forename: Wagih
authors.initials: W
authors.lastname: Ben Hassen
authors.affiliation: Departments of Neuroradiology, Centre Hospitalier Sainte-Anne, Université Paris Descartes, Sorbonne Paris Cité, INSERM UMR894, 1 rue Cabanis, 75014, Paris, France.
authors.forename: Myriam
authors.initials: M
authors.lastname: Edjlali
authors.affiliation: Department of Reanimation, Centre Hospitalier Sainte-Anne, Paris, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Sermet
authors.affiliation: Department of Reanimation, Centre Hospitalier Sainte-Anne, Paris, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Laquay
authors.affiliation: Departments of Neuroradiology, Centre Hospitalier Sainte-Anne, Université Paris Descartes, Sorbonne Paris Cité, INSERM UMR894, 1 rue Cabanis, 75014, Paris, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Trystram
authors.affiliation: Departments of Neuroradiology, Centre Hospitalier Sainte-Anne, Université Paris Descartes, Sorbonne Paris Cité, INSERM UMR894, 1 rue Cabanis, 75014, Paris, France.
authors.forename: Fawaz
authors.initials: F
authors.lastname: Al-Shareef
authors.affiliation: Departments of Neuroradiology, Centre Hospitalier Sainte-Anne, Université Paris Descartes, Sorbonne Paris Cité, INSERM UMR894, 1 rue Cabanis, 75014, Paris, France.
authors.forename: Jean-Francois
authors.initials: JF
authors.lastname: Meder
authors.affiliation: Department of Neurosurgery, Centre Hospitalier Sainte-Anne, Université Paris-Descartes, Paris, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Devaux
authors.affiliation: Departments of Neuroradiology, Centre Hospitalier Sainte-Anne, Université Paris Descartes, Sorbonne Paris Cité, INSERM UMR894, 1 rue Cabanis, 75014, Paris, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Oppenheim
authors.affiliation: Departments of Neuroradiology, Centre Hospitalier Sainte-Anne, Université Paris Descartes, Sorbonne Paris Cité, INSERM UMR894, 1 rue Cabanis, 75014, Paris, France. o.naggara@ch-sainte-anne.fr.
authors.forename: Olivier
authors.initials: O
authors.lastname: Naggara
mesh_terms: D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
keywords: CT perfusion; Cerebral vasospasm; Delayed cerebral ischemia; Prediction; Subarachnoid haemorrhage