Long-term Impact of Perfusion CT Data After Subarachnoid Hemorrhage

Overview

Journal Neuroradiology

Specialties Neurology
Radiology

Date 2013 Sep 13

PMID 24026709

Citations 9

Authors

Christian Mathys

Daniel Martens

Dorothea C Reichelt

Julian Caspers

Joel Aissa

Rebecca May

Daniel Hanggi

Gerald Antoch

Bernd Turowski

Affiliations

Soon will be listed here.

Abstract

Introduction: 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.

Conclusion: 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.

Citing Articles

Impact of Implementing an Elaborated CT Perfusion Protocol for Aneurysmal SAH on Functional Outcome: CTP Protocol for SAH.

Malinova V, Doring K, Psychogios M, Rohde V, Mielke D AJNR Am J Neuroradiol. 2021; 42(11):1956-1961.

PMID: 34556476 PMC: 8583263. DOI: 10.3174/ajnr.A7279.

MTT Heterogeneity in Perfusion CT Imaging as a Predictor of Outcome after Aneurysmal SAH.

Hofmann B, Fischer I, Engel A, Jannusch K, Donaldson D, Karadag C AJNR Am J Neuroradiol. 2021; 42(8):1387-1395.

PMID: 34083263 PMC: 8367610. DOI: 10.3174/ajnr.A7169.

Computed tomography perfusion as a predictor of delayed cerebral ischemia and functional outcome in spontaneous subarachnoid hemorrhage: A single center experience.

Fragata I, Alves M, Papoila A, Paiva Nunes A, Ferreira P, Diogo M Neuroradiol J. 2019; 32(3):179-188.

PMID: 30777482 PMC: 6512206. DOI: 10.1177/1971400919829048.

Prediction of outcome after aneurysmal subarachnoid haemorrhage using data from patient admission.

Rubbert C, Patil K, Beseoglu K, Mathys C, May R, G Kaschner M Eur Radiol. 2018; 28(12):4949-4958.

PMID: 29948072 DOI: 10.1007/s00330-018-5505-0.

An introduction to the pathophysiology of aneurysmal subarachnoid hemorrhage.

van Lieshout J, Dibue-Adjei M, Cornelius J, Slotty P, Schneider T, Restin T Neurosurg Rev. 2017; 41(4):917-930.

PMID: 28215029 DOI: 10.1007/s10143-017-0827-y.

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