title: Computed Tomography Perfusion Deficits during the Baseline Period in Aneurysmal Subarachnoid Hemorrhage Are Predictive of Delayed Cerebral Ischemia.
abstract: OBJECTIVE
  Delayed cerebral ischemia (DCI) is a frequent and fearful complication following aneurysmal subarachnoid hemorrhage (aSAH). The aim of this study is to assess the diagnostic accuracy of computed tomography perfusion (CTP) during an admission baseline period for the prediction of DCI.
  
  
  METHODS
  Fifty-four aSAH cases were screened by baseline CTP within 3 days after aSAH and were reexamined with CTP 7-17 days after aSAH. Relative cerebral blood volume, relative cerebral blood flow (CBF), and relative mean transit time were measured. DCI was confirmed by a combination of noncontrast CT, CTP reexamination, and clinical assessment of neurologic deficits. Quantitative baseline and reexamination CTP data for all patients were compared between DCI and without DCI groups using Student's t-tests. The quantitative baseline and reexamination CTP data of DCI patients were compared using paired Student's t-tests. The χ2test was used to evaluate incidences of DCI between different baseline relative CBF levels. The optimal cutoff value for each parameter was established by receiver operating characteristic curve analysis.
  
  
  RESULTS
  Of the patients included in this study, 33.3% (18 of 54) developed DCI. There was a significant difference in the incidence of DCI among different baseline relative CBF subsets (χ2= 38.00, P < .05). A relative CBF of .84 had the highest specificity and sensitivity of predicting DCI.
  
  
  CONCLUSIONS
  CTP parameters during the baseline period can be helpful for the early identification of aSAH patients who are at high risk for DCI.
authors: Department of Radiology, Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors: Yuxia
authors: Y
authors: Duan
authors: Department of Radiology, Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors: Haoli
authors: H
authors: Xu
authors: Department of Radiology, Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors: Rui
authors: R
authors: Li
authors: Department of Radiology, Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors: Kuikui
authors: K
authors: Zheng
authors: Department of Radiology, Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors: Zilong
authors: Z
authors: Hu
authors: Department of Radiology, Shandong Provincial Qianfoshan Hospital, No.16766, Jingshi Street, Jinan, Shandong, 250014, China.
authors: Nan
authors: N
authors: Wu
authors: Department of Radiology, Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors: Yunjun
authors: Y
authors: Yang
authors: Department of Neurosurgery, Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors: Qichuan
authors: Q
authors: Zhuge
authors: Department of Radiology, Zhejiang Provincial Key Laboratory of Aging and Neurological Disorder Research, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China. Electronic address: wyyycwj@163.com.
authors: Weijian
authors: W
authors: Chen
mesh_terms: D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology*; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging; D010477:Perfusion; D011237:Predictive Value of Tests; D012372:ROC Curve; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging*; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: Aneurysm; cerebral ischemia; perfusion; subarachnoid hemorrhage