Document Detail


Dynamic perfusion computed tomography in the diagnosis of cerebral vasospasm.
MedLine Citation:
PMID:  16883171     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The aim of the study was to correlate absolute cerebral blood flow (CBF) and mean transient time (MTT) measured by dynamic perfusion computed tomographic (PCT) scanning with the clinical course, vasospasm severity, and perfusion abnormality in patients with cerebral vasospasm after aneurysmal subarachnoid hemorrhage. METHODS: Forty-six patients with vasospasm after aneurysmal subarachnoid hemorrhage had 63 PCT images obtained during the course of vasospasm. All patients had transcranial Doppler measurements, 28 had an angiography study, and 38 had 99mTc single-photon emission computed tomographic imaging performed in conjunction with the PCT scan. RESULTS: The average minimal regional CBF (rCBF) and maximal regional MTT in patients with delayed ischemic deficit were significantly different in comparison with patients without delayed ischemic deficit (22.6 +/- 11.2 cm3/100 g/min versus 45.2 +/- 21.3 cm3/100 g/min, P < 0.001; 7.3 +/- 2.5 s versus 3.3 +/- 1.7 s, P < 0.05). The average minimal rCBF and maximal regional MTT in middle cerebral vascular territories in which severe middle cerebral artery vasospasm was measured by transcranial Doppler were significantly different in comparison with middle cerebral vascular territories in which no vasospasm was measured by transcranial Doppler (29.3 +/- 1.7 cm3/100 g/min versus 54.1 +/- 25.4 cm3/100 g/min, P < 0.01; 4.5 +/- 2.4 s versus 2.8 +/- 1.1 P < 0.001). The average minimal rCBF and maximal rMTT in vascular territories with estimated severe hypoperfusion on single-photon emission computed tomographic imaging were significantly different in comparison with values in vascular territories with unimpaired perfusion as estimated by single-photon emission computed tomographic imaging (18.9 +/- 6.9 cm3/100 g/min versus 54.2 +/- 23.4 cm3/100 g/min, P < 0.001, 0.001; 8.1 +/- 1.9 s versus 2.5 +/- 0.39 s, P < 0.001). CONCLUSION: 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.
Authors:
Gill E Sviri; Gavin W Britz; David H Lewis; David W Newell; Menashe Zaaroor; Wendy Cohen
Publication Detail:
Type:  Clinical Trial; Journal Article; Validation Studies    
Journal Detail:
Title:  Neurosurgery     Volume:  59     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-02     Completed Date:  2006-09-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  319-25; discussion 319-25     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Rambam (Maimonides) Medical Center, Haifa, Israel. sviri@u.washignton.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Brain Ischemia / etiology,  physiopathology,  radiography
Cerebral Arteries / physiopathology*,  radiography*,  radionuclide imaging
Cerebrovascular Circulation / physiology
Female
Humans
Image Processing, Computer-Assisted / methods
Male
Middle Aged
Predictive Value of Tests
Reproducibility of Results
Subarachnoid Hemorrhage / complications*
Time Factors
Tomography, Emission-Computed, Single-Photon
Tomography, X-Ray Computed / instrumentation,  methods*
Vasospasm, Intracranial / etiology,  physiopathology*,  radiography*

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