OBJECTIVE: To prospectively assess the diagnostic accuracy of CT perfusion (CTP) and transcranial Doppler sonography (TCD) for the prediction of secondary cerebral infarction (SCI) after aneurysmal subarachnoid hemorrhage (SAH). METHODS: During 2 weeks after SAH, 38 consecutive patients completed an average of 3.5 CT/CTP and 10.7 TCD examinations at regular intervals as required by the study protocol. SCI was defined as delayed infarction on native CT between 3 and 14 days after SAH and developed in n = 14 patients (n = 24 without SCI). Analysis was based on examination dates before SCI. Common measures of diagnostic accuracy were calculated for qualitative CTP (visual color-map ratings from two blinded observers) and TCD assessments (mean flow velocity >120 cm/s in anterior, middle, and posterior cerebral artery territories). Quantitative measures, which for CTP were obtained from cortical a priori regions of interest corresponding to the vascular territories, were analyzed by binary logistic regression. RESULTS: Time of prediction for SCI by CTP was at a median of 3 days (range 2 to 5 days) before manifestation of complete infarction on native CT. Visual assessment of time-to-peak (TTP) color maps performed best for the prediction of SCI with 0.93 sensitivity (95% CI: 0.7 to 1.0) and 0.67 specificity (95% CI: 0.53 to 0.7). On quantitative analysis, the odds ratio (OR) for 1 second of side-to-side delay in TTP was 1.4 (p = 0.01, Wald chi(2) = 8.57, CI: 1.07 to 1.82). Daily TCD measures were not significantly related to SCI at any time before complete infarction on native CT. CONCLUSIONS: Time to peak as indicated by CT perfusion is a sensitive and early predictor of secondary cerebral infarction.
OBJECTIVE: To prospectively assess the diagnostic accuracy of CT perfusion (CTP) and transcranial Doppler sonography (TCD) for the prediction of secondary cerebral infarction (SCI) after aneurysmal subarachnoid hemorrhage (SAH). METHODS: During 2 weeks after SAH, 38 consecutive patients completed an average of 3.5 CT/CTP and 10.7 TCD examinations at regular intervals as required by the study protocol. SCI was defined as delayed infarction on native CT between 3 and 14 days after SAH and developed in n = 14 patients (n = 24 without SCI). Analysis was based on examination dates before SCI. Common measures of diagnostic accuracy were calculated for qualitative CTP (visual color-map ratings from two blinded observers) and TCD assessments (mean flow velocity >120 cm/s in anterior, middle, and posterior cerebral artery territories). Quantitative measures, which for CTP were obtained from cortical a priori regions of interest corresponding to the vascular territories, were analyzed by binary logistic regression. RESULTS: Time of prediction for SCI by CTP was at a median of 3 days (range 2 to 5 days) before manifestation of complete infarction on native CT. Visual assessment of time-to-peak (TTP) color maps performed best for the prediction of SCI with 0.93 sensitivity (95% CI: 0.7 to 1.0) and 0.67 specificity (95% CI: 0.53 to 0.7). On quantitative analysis, the odds ratio (OR) for 1 second of side-to-side delay in TTP was 1.4 (p = 0.01, Wald chi(2) = 8.57, CI: 1.07 to 1.82). Daily TCD measures were not significantly related to SCI at any time before complete infarction on native CT. CONCLUSIONS: Time to peak as indicated by CT perfusion is a sensitive and early predictor of secondary cerebral infarction.
Authors: A E Othman; S Afat; C Brockmann; O Nikoubashman; G Bier; M A Brockmann; K Nikolaou; J H Tai; Z P Yang; J H Kim; M Wiesmann Journal: Clin Neuroradiol Date: 2015-12-15 Impact factor: 3.649
Authors: Ahmed E Othman; Carolin Brockmann; Zepa Yang; Changwon Kim; Saif Afat; Rastislav Pjontek; Omid Nikoubashman; Marc A Brockmann; Jong Hyo Kim; Martin Wiesmann Journal: Eur Radiol Date: 2015-04-23 Impact factor: 5.315
Authors: Ahmed E Othman; Carolin Brockmann; Zepa Yang; Changwon Kim; Saif Afat; Rastislav Pjontek; Omid Nikoubashman; Marc A Brockmann; Konstantin Nikolaou; Martin Wiesmann; Jong Hyo Kim Journal: Eur Radiol Date: 2015-05-30 Impact factor: 5.315
Authors: P C Sanelli; I Ugorec; C E Johnson; J Tan; A Z Segal; M Fink; L A Heier; A J Tsiouris; J P Comunale; M John; P E Stieg; R D Zimmerman; A I Mushlin Journal: AJNR Am J Neuroradiol Date: 2011-09-29 Impact factor: 3.825
Authors: Ahmed E Othman; Saif Afat; Omid Nikoubashman; Marguerite Müller; Gerrit Alexander Schubert; Georg Bier; Marc A Brockmann; Martin Wiesmann; Carolin Brockmann Journal: Neuroradiology Date: 2016-05-18 Impact factor: 2.804
Authors: Jan W Dankbaar; Mienke Rijsdijk; Irene C van der Schaaf; Birgitta K Velthuis; Marieke J H Wermer; Gabriel J E Rinkel Journal: Neuroradiology Date: 2009-07-22 Impact factor: 2.804