Diagnostic threshold values of predicting delayed cerebral ischemia after subarachnoid hemorrhage with computed tomography perfusion

He Qiuguang; Wu Jingchuan; Guo Zongduo; Zhang Xiaodong; He Zhaohui; Zhu Ji; Sun Xiaochuan; Zhou Meng; Lü Fajin

doi:10.13406/j.cnki.cyxb.000930

您当前的位置：

首页 >

文章列表页 >

Diagnostic threshold values of predicting delayed cerebral ischemia after subarachnoid hemorrhage with computed tomography perfusion

更新时间：2024-01-17

- Diagnostic threshold values of predicting delayed cerebral ischemia after subarachnoid hemorrhage with computed tomography perfusion
- Journal of Chongqing Medical University Vol. 41, Issue 8, Pages: 850-854(2016)
- 作者机构：
  
  1. 重庆医科大学附属第一医院神经外科
  2. 重庆医科大学附属第一医院放射科
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.000930
  CLC： R743.35
- Published：2016，
扫描看全文
[1]何秋光,吴精川,郭宗铎,张晓冬,何朝晖,朱继,孙晓川,周孟,吕发金.CT灌注成像预测蛛网膜下腔出血后迟发性脑缺血的诊断价值研究[J].重庆医科大学学报,2016,41(08):850-854.

He Qiuguang, Wu Jingchuan, Guo Zongduo, et al. Diagnostic threshold values of predicting delayed cerebral ischemia after subarachnoid hemorrhage with computed tomography perfusion. [J]. Journal of Chongqing Medical University 41(8):850-854(2016)
[1]何秋光,吴精川,郭宗铎,张晓冬,何朝晖,朱继,孙晓川,周孟,吕发金.CT灌注成像预测蛛网膜下腔出血后迟发性脑缺血的诊断价值研究[J].重庆医科大学学报,2016,41(08):850-854. DOI： 10.13406/j.cnki.cyxb.000930.

He Qiuguang, Wu Jingchuan, Guo Zongduo, et al. Diagnostic threshold values of predicting delayed cerebral ischemia after subarachnoid hemorrhage with computed tomography perfusion. [J]. Journal of Chongqing Medical University 41(8):850-854(2016) DOI： 10.13406/j.cnki.cyxb.000930.

摘要

目的:探讨CT灌注成像（CT perfusion

CTP）预测蛛网膜下腔出血（subarachnoid hemorrhage

SAH）后迟发性脑缺血（delayed cerebral ischemia

DCI）的临床价值。方法:回顾性分析122例SAH患者临床资料

记录CTP相关参数

包括脑血流量（cerebral blood flow

CBF）、脑血容量（cerebral blood volume

CBV）、平均通过时间（mean transit time

MTT）及达峰时间（time to peak

TTP）。根据病程中有无DCI

将研究对象分为DCI组和Non-DCI组

比较两组间CTP参数的差异

使用ROC曲线评价各参数对DCI早期预测的价值。结果:122例患者中

发生DCI 43例

未发生DCI 79例。DCI组的CBF值低于Non-DCI组

MTT、TTP较后者延长

双侧灌注差异更为显著（P<0.05）。CBF、CBV、CBF比值、CBV比值、MTT、TTP、MTT差值、TTP差值的ROC曲线下面积分别为:0.87、0.69、0.81、0.76、0.88、0.72、0.71、0.78;预测DCI最佳诊断界值分别为:15.91 ml/（min·ml）、1.76 ml/100 g、0.84、0.83、9.65、11.46、0.68、0.48 s。MTT、CBF、CBF比值预测DCI价值较高

其敏感度和特异度分别为:69.77%和93.67%、72.10%和88.60%、69.77%和91.14%。结论:SAH后脑微循环的状态能通过CTP检查来评估

CTP检查在早期预测DCI的发生具有一定的可靠性。

Abstract

Objective:To observe the diagnostic threshold values of predicting delayed cerebral ischemia(DCI)after subarachnoid hemorrhage(SAH)with computed tomography perfusion(CTP). Methods:Totally 122 patients with SAH were respectively enrolled.CT perfusion values

including cerebral blood flow(CBF)

cerebral blood volume(CBV)

mean transit time(MTT)

and time to peak(TTP)in predefined regions of interest were measured. All patients were divided into DCI group and non-DCI group. Diagnostic threshold values for DCI were evaluated and sensitivity and specificity were calculated for optimal thresholds. Results:Of 122 patients with SAH

43 had DCI

79 didn’t have DCI. The CBF was lower

MTT and TTP was longer and perfusion asymmetry was lager in DCI group than in non-DCI group(P<0.05). The areas under ROC curves of CBF

CBV

CBF ratio

CBV ratio

MTT

TTP

MTT difference

TTP difference were 0.87

0.69

0.81

0.76

0.88

0.72

0.71

0.78;the optimal threshold values were 15.91ml/(min·ml)

1.76 ml/100 g

0.84

0.83

9.65

11.46

0.68

0.48 s. MTT

CBF

CBF ratio had high diagnostic value in predicting DCI and the sensitivity and specificity were MTT of 69.77% and 93.67%

CBF of 72.10% and 88.60% and CBF of 69.77% and 91.14%. Conclusion:The cerebral microcirculation hemodynamic after SAH can be evaluated by CTP. CT perfusion is an early and reliable predictor of DCI.

关键词

蛛网膜下腔出血CT灌注成像迟发性脑缺血脑微循环

Keywords

subarachnoid hemorrhageCT perfusiondelayed cerebral ischemiaCerebral microcirculation

references

Views

112

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Correlation between the early coagulation function and delayed cerebral ischemia after aSAH

Clinical value of intracranial pressure monitoring after clipping of intracranial aneurysm

Elementary investigaion of curative effects by DUXIL on cerebral dysfunction associated with disturbance of cerebral microcirculation

A new animal model of subarachnoid hemorrhage in the anterior circulation

Association of Apolipoprotein E genotypes polymorphisms with cerebral vasospasm after spontaneous subarachnoid hemorrhage

Related Author

Mao Lei

Yuan Yuqing

Cheng Chongjie

Wu Jingchuan

Chai Weina

Jiang Dengzhi

Zhang Xiaodong

Sun Xiaochuan

Related Institution

Department of Neurosurgery,The Third People’s Hospital of Chengdu

Department of Nurosurgery,The First Affiliated Hospital of Chongqing Medical University

重庆医科大学附属第一医院神内科

Department of Internal Medicine,the People’s Hospital of U’shan

重庆医科大学附属第二医院神经外科

⁰