Perfusion Computed Tomography and Trancranial Doppler in Aneurysmal Subarachnoid Hemorrhage

Paik, Seung Jung; Kim, Jong Yeon; Lee, Hee Keun; Hu, Chul; Lee, Myung Sub; Pyen, Jhin Soo; Kim, Hun Joo

Abstract

OBJECT: This study is designed to estimate the clinical usefulness of perfusion computed tomography (perfusion CT) as an easily accessible tool to evaluate cerebral blood flow (CBF) in patients with aneurysmal subarachnoid hemorrhage. METHOD: Twenty patients with aneurysmal spontaneous subarachnoid hemorrhage who underwent either aneurysmal neck clipping or interventional coil embolization and who also had taken transcranial doppler study and perfusion CT were included as study group. And as a control group, fifteen patients without neurologic deficit were studied with the same devices. We compared the cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) from obtained perfusion CT with the results of transcranial doppler and clinical course.
RESULTS
CBF parameters of perfusion CT in control group showed close accordance with those values of reported xenon CT and positron emission tomography data. In doppler study, the blood flow velocity was higher in cases with vasospasm than without it (p=0.027). There showed significant relationship between vasospasm and perfusion CT parameters, as decrease in CBF (p=0.061) and increase in MTT (p=0.013). Perfusion CT parameters were closely correlated with TCD parameters in clinical vasospasm as reverse correlation in CBF (R2=0.45) and positive in MTT (R2=0.58).
CONCLUSION
The cerebral blood flow parameters of Perfusion CT showed reliable and accurate values in control group. The perfusion CT and TCD can be used as easily accessible non-invasive tools to evaluate cerebral blood flow parameters in clinical settings of patients with aneurysmal subarachnoid hemorrhage.