TY - JOUR
T1 - Perfusion-CT assessment of blood-brain barrier permeability in patients with aneurysmal subarachnoid hemorrhage
AU - Kishore, Sirish
AU - Ko, Nerissa
AU - Soares, Bruno P.
AU - Higashida, Randall T.
AU - Tong, Elizabeth
AU - Bhogal, Sumail
AU - Bredno, Joerg
AU - Cheng, Su Chun
AU - Wintermark, Max
N1 - Funding Information:
Sirish Kishore was supported by the UCSF Clinical and Translational Science Institute, NIH/NCRR/OD UCSF-CTSI Grant Number TL1 RR024129.
Funding Information:
Max Wintermark receives funding from the National Center for Research Resources, Grant KL2 RR024130, GE Healthcare and Philips Medical Systems.
PY - 2012/12
Y1 - 2012/12
N2 - Background: The goal of this study was to determine which clinical and radiographic variables in patients with subarachnoid hemorrhage (SAH) are associated with in vivo blood-brain barrier permeability (BBBP) assessments obtained using perfusion-CT (PCT) technology. Methods: SAH patients with confirmed aneurysm etiology and with PCT and angiogram within 24. hours of each other were included, and relationships between clinical and imaging variables were analyzed using random-effects generalized linear models. Results: One thousand one hundred and sixty two vascular territories from 83 patients were evaluated in this study. The mean BBBP increased by severity of vasospasm on DSA, however, in multivariate analysis, only mean transit time (MTT), cerebral blood volume (CBV), and severity of hydrocephalus were significantly associated with BBBP. Increased BBBP was not associated with angiographic vasospasm severity in multivariate analysis. Conclusion: Perfusion-CT assessment of BBBP may serve as a unique and useful biomarker in conjunction with angiography, additional perfusion-CT parameters, and clinical assessments, especially in characterizing microvascular dysfunction, or even in targeting treatments. However, future prospective studies will be required to definitively establish its clinical utility in the care of SAH patients.
AB - Background: The goal of this study was to determine which clinical and radiographic variables in patients with subarachnoid hemorrhage (SAH) are associated with in vivo blood-brain barrier permeability (BBBP) assessments obtained using perfusion-CT (PCT) technology. Methods: SAH patients with confirmed aneurysm etiology and with PCT and angiogram within 24. hours of each other were included, and relationships between clinical and imaging variables were analyzed using random-effects generalized linear models. Results: One thousand one hundred and sixty two vascular territories from 83 patients were evaluated in this study. The mean BBBP increased by severity of vasospasm on DSA, however, in multivariate analysis, only mean transit time (MTT), cerebral blood volume (CBV), and severity of hydrocephalus were significantly associated with BBBP. Increased BBBP was not associated with angiographic vasospasm severity in multivariate analysis. Conclusion: Perfusion-CT assessment of BBBP may serve as a unique and useful biomarker in conjunction with angiography, additional perfusion-CT parameters, and clinical assessments, especially in characterizing microvascular dysfunction, or even in targeting treatments. However, future prospective studies will be required to definitively establish its clinical utility in the care of SAH patients.
KW - Blood-brain barrier
KW - Endothelial dysfunction
KW - Perfusion-CT
KW - Stroke
KW - Subarachnoid hemorrhage
KW - Vasospasm
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U2 - 10.1016/j.neurad.2011.11.004
DO - 10.1016/j.neurad.2011.11.004
M3 - Article
C2 - 22197406
AN - SCOPUS:84870654408
VL - 39
SP - 317
EP - 325
JO - Journal of Neuroradiology
JF - Journal of Neuroradiology
SN - 0150-9861
IS - 5
ER -