Quantification du vasospasme cérébral après hémorragie sous-arachnoïdienne par scanner de perfusion

Translated title of the contribution: Perfusion CT to quantify the cerebral vasospasm following subarachnoid hemorrhage

Virginie Lefournier, Alexandre Krainik, Benjamin Gory, Frédéric Derderian, Pierre Bessou, Bertrand Fauvage, Jean François Le Bas, Jean François Payen

Research output: Contribution to journalArticle

Abstract

Background and purpose: After subarachnoid hemorrhage (SAH), vasospasm is frequent and increases the risk of stroke and poor clinical outcome. The purpose of this study was to identify the best perfusion parameters in perfusion-CT (PCT) able to predict vasospasm diagnosed by angiography after SAH. Methods: Seventy-six patients with SAH were investigated by PCT and cerebral angiography. Using regions of interest (ROI) on parametric maps of mean transit time (MTT), time to peak (TTP), cerebral blood volume (CBV) and cerebral blood flow (CBF), PCT data were compared to an arteriographic score in two categories (severe vasospasm: ≥ 50% and non-severe vasospasm: <50%) for each artery. Best PCT predictors of the arteriographic score were tested using multiparametric logistic regression. Results: Among the 76 patients, PCT data were reliable in 65 patients. Twenty-seven patients had a severe vasospasm. Logistic regression showed that MTT was the best predictor of the arteriographic score. Using MTT, odds ratios having a vasospasm were superior to 3.1 and the occurrence of a vasospasm was accurately predicted in 78.5 to 100%, depending on the artery considered. However, no absolute value of the MTT could be identified to predict the occurrence of vasospasm. In fact, abnormal values of MTT ranged from 123 to 221% (m = 146%) of the control values. Discussion and conclusions: PCT may accurately identify severe vasospasm and might be used as a convenient noninvasive imaging modality to monitor patients with SAH. When detected, severe vasospasm could be confirmed and managed using angiography and endovascular treatment, appropriately.

Original languageFrench
Pages (from-to)284-291
Number of pages8
JournalJournal of Neuroradiology
Volume37
Issue number5
DOIs
StatePublished - Dec 2010
Externally publishedYes

Fingerprint

Intracranial Vasospasm
Subarachnoid Hemorrhage
Perfusion
Cerebrovascular Circulation
Angiography
Arteries
Logistic Models
Cerebral Angiography
Stroke
Odds Ratio

Keywords

  • Cerebral angiography
  • Perfusion computed tomography
  • Subarachnoid hemorrhage
  • Vasospasm

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Lefournier, V., Krainik, A., Gory, B., Derderian, F., Bessou, P., Fauvage, B., ... Payen, J. F. (2010). Quantification du vasospasme cérébral après hémorragie sous-arachnoïdienne par scanner de perfusion. Journal of Neuroradiology, 37(5), 284-291. https://doi.org/10.1016/j.neurad.2010.03.003

Quantification du vasospasme cérébral après hémorragie sous-arachnoïdienne par scanner de perfusion. / Lefournier, Virginie; Krainik, Alexandre; Gory, Benjamin; Derderian, Frédéric; Bessou, Pierre; Fauvage, Bertrand; Le Bas, Jean François; Payen, Jean François.

In: Journal of Neuroradiology, Vol. 37, No. 5, 12.2010, p. 284-291.

Research output: Contribution to journalArticle

Lefournier, V, Krainik, A, Gory, B, Derderian, F, Bessou, P, Fauvage, B, Le Bas, JF & Payen, JF 2010, 'Quantification du vasospasme cérébral après hémorragie sous-arachnoïdienne par scanner de perfusion', Journal of Neuroradiology, vol. 37, no. 5, pp. 284-291. https://doi.org/10.1016/j.neurad.2010.03.003
Lefournier, Virginie ; Krainik, Alexandre ; Gory, Benjamin ; Derderian, Frédéric ; Bessou, Pierre ; Fauvage, Bertrand ; Le Bas, Jean François ; Payen, Jean François. / Quantification du vasospasme cérébral après hémorragie sous-arachnoïdienne par scanner de perfusion. In: Journal of Neuroradiology. 2010 ; Vol. 37, No. 5. pp. 284-291.
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abstract = "Background and purpose: After subarachnoid hemorrhage (SAH), vasospasm is frequent and increases the risk of stroke and poor clinical outcome. The purpose of this study was to identify the best perfusion parameters in perfusion-CT (PCT) able to predict vasospasm diagnosed by angiography after SAH. Methods: Seventy-six patients with SAH were investigated by PCT and cerebral angiography. Using regions of interest (ROI) on parametric maps of mean transit time (MTT), time to peak (TTP), cerebral blood volume (CBV) and cerebral blood flow (CBF), PCT data were compared to an arteriographic score in two categories (severe vasospasm: ≥ 50{\%} and non-severe vasospasm: <50{\%}) for each artery. Best PCT predictors of the arteriographic score were tested using multiparametric logistic regression. Results: Among the 76 patients, PCT data were reliable in 65 patients. Twenty-seven patients had a severe vasospasm. Logistic regression showed that MTT was the best predictor of the arteriographic score. Using MTT, odds ratios having a vasospasm were superior to 3.1 and the occurrence of a vasospasm was accurately predicted in 78.5 to 100{\%}, depending on the artery considered. However, no absolute value of the MTT could be identified to predict the occurrence of vasospasm. In fact, abnormal values of MTT ranged from 123 to 221{\%} (m = 146{\%}) of the control values. Discussion and conclusions: PCT may accurately identify severe vasospasm and might be used as a convenient noninvasive imaging modality to monitor patients with SAH. When detected, severe vasospasm could be confirmed and managed using angiography and endovascular treatment, appropriately.",
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AU - Lefournier, Virginie

AU - Krainik, Alexandre

AU - Gory, Benjamin

AU - Derderian, Frédéric

AU - Bessou, Pierre

AU - Fauvage, Bertrand

AU - Le Bas, Jean François

AU - Payen, Jean François

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AB - Background and purpose: After subarachnoid hemorrhage (SAH), vasospasm is frequent and increases the risk of stroke and poor clinical outcome. The purpose of this study was to identify the best perfusion parameters in perfusion-CT (PCT) able to predict vasospasm diagnosed by angiography after SAH. Methods: Seventy-six patients with SAH were investigated by PCT and cerebral angiography. Using regions of interest (ROI) on parametric maps of mean transit time (MTT), time to peak (TTP), cerebral blood volume (CBV) and cerebral blood flow (CBF), PCT data were compared to an arteriographic score in two categories (severe vasospasm: ≥ 50% and non-severe vasospasm: <50%) for each artery. Best PCT predictors of the arteriographic score were tested using multiparametric logistic regression. Results: Among the 76 patients, PCT data were reliable in 65 patients. Twenty-seven patients had a severe vasospasm. Logistic regression showed that MTT was the best predictor of the arteriographic score. Using MTT, odds ratios having a vasospasm were superior to 3.1 and the occurrence of a vasospasm was accurately predicted in 78.5 to 100%, depending on the artery considered. However, no absolute value of the MTT could be identified to predict the occurrence of vasospasm. In fact, abnormal values of MTT ranged from 123 to 221% (m = 146%) of the control values. Discussion and conclusions: PCT may accurately identify severe vasospasm and might be used as a convenient noninvasive imaging modality to monitor patients with SAH. When detected, severe vasospasm could be confirmed and managed using angiography and endovascular treatment, appropriately.

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