Dynamic Perfusion Computed Tomography in the Diagnosis of Cerebral Vasospasm

Abstract

The present study suggests that, in general, quantitative measurements of rCBF and regional MTT by PCT show high concordance rates with the clinical course, vasospasm severity, and hemodynamic impairments in patients with cerebral vasospasm aneurysmal subarachnoid hemorrhage.

Early Cerebral Circulatory Disturbance in Patients Suffering Subarachnoid Hemorrhage Prior to the Delayed Cerebral Vasospasm Stage: Xenon Computed Tomography and Perfusion Computed Tomography Study

“…1) This finding may also be useful in the acute phase of cerebral infarction. 19,24,27,29) This is in agreement with the changes in CBF and MTT observed during delayed CVS, 12,25,28) which are considered to suggest cerebral circulatory disturbance. Also, a threshold MTT value for diagnosing CVS has been reported, but it varies depending on the perfusion CT protocol, software, and hardware used at individual centers.…”

“…However, many such studies have investigated the cerebral circulation and metabolism during delayed CVS, and few have examined the cerebral circulation and metabolism in the early stage before the development of delayed CVS. [5][6][7]11,20,25,26) The cerebral circulation is impaired from the early stages after SAH onwards and CBF is markedly reduced in severe cases. 23) We also confirmed that CBF decreased as the neurological grade increased.…”

“…6,11,20) Recently, computed tomography (CT) perfusion imaging has been used to assess patients with delayed CVS. 12,25,28) A number of hemodynamic parameters are available for CT perfusion imaging. One such parameter, the mean transit time (MTT), is defined as the mean time required for blood to perfuse through a region of tissue, and is highly sensitive to hemodynamic disturbances.…”

“…There have been several investigations of cerebral circulatory disturbance during the delayed CVS phase using MTT. 4,14,25,28) MTT was identified as the most sensitive perfusion parameter for detecting delayed CVS. 28) However, few investigations have attempted to explain circulatory disturbances using MTT and cerebral blood volume (CBV) during the early phase before delayed CVS.…”

Evaluating the diagnostic accuracy of CT perfusion in patients with cerebral vasospasm after aneurysm rupture: a meta-analysis

“…As relevant studies for this analysis, 6 articles underwent full-text search and assessment, and only one article met the inclusion criteria. Three articles were excluded because the reported data could not construct the fourfold tables (6,12,16). Two articles were not included because one was a reduplicated study (8) and one was a conference abstract.…”