Shin B J, Anumula N, Hurtado-Rúa S, Masi P, Campbell R, Spandorfer R, Ferrone A, Caruso T, Haseltine J, Robinson C, Gupta A, Sanelli P C
Departments of Radiology.
AJNR Am J Neuroradiol. 2014 Jan;35(1):49-54. doi: 10.3174/ajnr.A3655. Epub 2013 Aug 14.
In recent years, there has been increasing use of CTP imaging in patients with aneurysmal SAH to evaluate for vasospasm. Given the critical role of the arterial input function for generation of accurate CTP data, several studies have evaluated the effect of varying the arterial input function location in patients with acute stroke. Our aim was to determine the effect on quantitative CTP data when the arterial input function location is distal to significant vasospasm in patients with aneurysmal SAH.
A retrospective study was conducted of patients with aneurysmal SAH admitted from 2005 to 2011. Inclusion criteria were the presence of at least 1 anterior cerebral artery or MCA vessel with a radiologically significant vasospasm and at least 1 of these vessels without vasospasm. We postprocessed each CTP dataset 4 separate times by using standardized methods, only varying the selection of the arterial input function location in the anterior cerebral artery and MCA vessels. For each of the 4 separately processed examinations for each patient, quantitative data for CBF, CBV, and MTT were calculated by region-of-interest sampling of the vascular territories. Statistical analysis was performed by using a linear mixed-effects model.
One hundred twelve uniquely processed CTP levels were analyzed in 28 patients (mean age, 52 years; 24 women and 4 men) recruited from January 2005 to December 2011. The average Hunt and Hess scale score was 2.89 ± 0.79. The average time to CTP from initial presentation was 8.2 ± 5.1 days. For each vascular territory (right and left anterior cerebral artery, MCA, posterior cerebral artery), there were no significant differences in the quantitative CBF, CBV, and MTT generated by arterial input function locations distal to significant vasospasm compared with nonvasospasm vessels (P > .05).
Arterial input function placement distal to significant vasospasm does not affect the quantitative CTP data in the corresponding vascular territory or any other vascular territory in aneurysmal SAH.
近年来，CTP成像在动脉瘤性蛛网膜下腔出血（SAH）患者中用于评估血管痉挛的应用日益增多。鉴于动脉输入函数对生成准确CTP数据的关键作用，多项研究评估了改变急性卒中患者动脉输入函数位置的影响。我们的目的是确定在动脉瘤性SAH患者中，当动脉输入函数位置位于严重血管痉挛的远端时，对定量CTP数据的影响。
对2005年至2011年收治的动脉瘤性SAH患者进行回顾性研究。纳入标准为至少有1条大脑前动脉或大脑中动脉血管存在放射学上显著的血管痉挛，且这些血管中至少有1条无血管痉挛。我们使用标准化方法对每个CTP数据集进行4次单独后处理，仅改变大脑前动脉和大脑中动脉血管中动脉输入函数位置的选择。对于每位患者的4次单独处理的检查，通过对血管区域进行感兴趣区采样来计算CBF、CBV和MTT的定量数据。使用线性混合效应模型进行统计分析。
对2005年1月至2011年12月招募的28例患者（平均年龄52岁；24例女性，4例男性）的112个经过独特处理的CTP水平进行了分析。Hunt和Hess量表平均评分为2.89±0.79。从首次就诊到进行CTP的平均时间为8.2±5.1天。对于每个血管区域（右侧和左侧大脑前动脉、大脑中动脉、大脑后动脉），与无血管痉挛的血管相比，严重血管痉挛远端的动脉输入函数位置所生成的定量CBF、CBV和MTT无显著差异（P>.05）。
在动脉瘤性SAH中，将动脉输入函数置于严重血管痉挛的远端不会影响相应血管区域或任何其他血管区域的定量CTP数据。
