Dynamic perfusion computerized tomography in cerebral vasospasm following aneurysmal subarachnoid hemorrhage: A comparison with technetium-99m-labeled ethyl cysteinate dimer-single-photon emission computerized tomography

Gill E. Sviri, Ali H. Mesiwala, David H. Lewis, Gavin W. Britz, Andrew Nemecek, David W. Newell, Arthur Lam, Wendy Cohen

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Object. The aim of this study was to correlate cerebral blood flow (CBF) and mean transient time (MTT) measured on dynamic perfusion computerized tomography (CT) with CBF using 99mTc ethyl cysteinate dimer-single-photon emission computerized tomography (SPECT) in patients with cerebral vasospasm following aneurysmal subarachnoid hemorrhage (SAH). Methods. Thirty-five patients with vasospasm following aneurysmal SAH (12 men and 23 women with a mean age of 49.3 ± 10.1 years) underwent imaging studies; thus, 35 perfusion CT scans and 35 SPECT images were available for comparison. The CBF and MTT values in 12 different brain regions were defined relative to the interhemispheric occipital cortex values using perfusion CT scans and were compared with qualitative relative (rel)CBF estimated on SPECT images. In brain regions with normal, mild (relCBF 71-85%), moderate (relCBF 50-70%), and severe (relCBF < 50%) hypoperfusion on SPECT, the mean relCBF values measured on perfusion CT were 1.01 ± 0.08, 0.82 ± 0.22, 0.6 ± 0.15, and 0.32 ± 0.08, respectively (p < 0.0001); the mean relMTT values were 1.04 ± 0.14, 1.4 ± 0.31, 2.16 ± 0.46, and 3.3 ± 0.54, respectively (p < 0.0001). All but one brain region (30 regions) with severe hypoperfusion on SPECT images demonstrated relCBF values less than 0.6 and relMTT values greater than 2.5 on perfusion CT scans. Conclusions. Relative CBF and MTT values on perfusion CT showed a high concordance rate with estimated rel-CBF on SPECT in patients with vasospasm following aneurysmal SAH. Given its logistical advantages, perfusion CT may be a valuable method of assessing perfusion abnormality in the acute setting of vasospasm and in patients with an unstable condition following aneurysmal SAH.

Original languageEnglish (US)
Pages (from-to)404-410
Number of pages7
JournalJournal of Neurosurgery
Volume104
Issue number3
DOIs
StatePublished - Mar 2006

Keywords

  • Cerebral blood flow
  • Computerized tomography
  • Perfusion computerized tomography
  • Single-photon emission computerized tomography
  • Subarachnoid hemorrhage
  • Vasospasm

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

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