%0 Journal Article
%T Can CT Perfusion Guide Patient Selection for Treatment of Delayed Cerebral Ischemia?
%A Rachel Gold
%A Pina C. Sanelli
%A Nikesh Anumula
%A Austin Ferrone
%A Carl E. Johnson
%A Joseph P. Comunale
%A Apostolos J. Tsiouris
%A Howard Riina
%A Halinder Mangat
%A Axel Rosengart
%A Alan Z. Segal
%J Advances in Computed Tomography
%P 4-12
%@ 2169-2483
%D 2013
%I Scientific Research Publishing
%R 10.4236/act.2013.21002
%X <p class=\"MsoNormal\">
	<b><span lang=\"EN-US\">Purpose: </span></b><span lang=\"EN-US\">To evaluate qualitative and quantitative CT perfusion (CTP) for different treatment options of delayed cere</span><span lang=\"EN-US\">bral ischemia (DCI) in aneurysmal SAH.</span><span lang=\"EN-US\"> </span><b><span lang=\"EN-US\">Methods: </span></b><span lang=\"EN-US\">Retrospective</span><span lang=\"EN-US\"> </span><span lang=\"EN-US\">study of consecutive SAH patients enrolled in a pros</span><span lang=\"EN-US\">pective IRB-approved clinical trial. Qualitative analysis of CTP deficits were determined by two blinded neuroradiolo</span><span lang=\"EN-US\">gists. Quantitative CTP was performed using standardized protocol with region-of-interest placement sampling the cor</span><span lang=\"EN-US\">tex. DCI was assessed by clinical and imaging criteria. Patients were classified into treatment groups: 1) hyperten</span><span lang=\"EN-US\">sion-hemodilution-hypervolemia (HHH)</span><span lang=\"EN-US\">;</span><span lang=\"EN-US\"> 2) intra-arterial (IA) vasodilators and/or angioplasty</span><span lang=\"EN-US\">;</span><span lang=\"EN-US\"> 3) no treatment. Mean quantitative CTP values were compared using ANOVA pairwise comparisons. Receiver operating characteristic (ROC) curves, standard error (SE) and optimal threshold values were calculated. <b>Results:</b></span><b><span lang=\"EN-US\"> </span></b><span lang=\"EN-US\">Ninety-six patients were classified into three treatment groups; 21</span><span lang=\"EN-US\">% </span><span lang=\"EN-US\">(19/96) HHH, 34</span><span lang=\"EN-US\">% </span><span lang=\"EN-US\">(33/96) IA-therapy and 46</span><span lang=\"EN-US\">% </span><span lang=\"EN-US\">(44/96) no treatment. DCI was diagnosed in 42</span><span lang=\"EN-US\">% </span><span lang=\"EN-US\">(40/96); of which 18</span><span lang=\"EN-US\">% </span><span lang=\"EN-US\">(7/40) received HHH, 80</span><span lang=\"EN-US\">% </span><span lang=\"EN-US\">(32/40) IA-therapy, and 2</span><span lang=\"EN-US\">% </span><span lang=\"EN-US\">(1/40) no treatment. CTP deficits were seen in 50</span><span lang=\"EN-US\">% </span><span lang=\"EN-US\">(48/96); occurring in 63</span><span lang=\"EN-US\">% </span><span lang=\"EN-US\">(12/19) HHH, 94</span><span lang=\"EN-US\">% </span><span lang=\"EN-US\">(31/33) IA-therapy, and 11</span><span lang=\"EN-US\">% </span><span lang=\"EN-US\">(5/44) no treat</span><span lang=\"EN-US\">ment. Presence of CTP deficits had 83% sensitivity, 89% specificity, 90% positive predictive and 81% negative predic</span><span
%K CT Perfusion
%K Aneurysmal Subarachnoid Hemorrhage
%K Delayed Cerebral Ischemia
%K Treatment
%U http://www.scirp.org/journal/PaperInformation.aspx?PaperID=28539