Whole-brain CT perfusion at different time for predicting clinical outcomes of patients with aneurysmal subarachnoid hemorrhage
10.13929/j.issn.1003-3289.2025.07.011
- VernacularTitle:基于不同时间全脑CT灌注预测动脉瘤性蛛网膜下腔出血患者临床结局
- Author:
Lei FENG
1
;
Chao ZHANG
;
Pengzhan YIN
;
Juan WANG
;
Chen YANG
;
Jinlong YUAN
;
Yunfeng ZHOU
Author Information
1. 皖南医学院第一附属医院放射科,安徽芜湖 241001
- Publication Type:Journal Article
- Keywords:
intracranial aneurysm;
subarachnoid hemorrhage;
prognosis;
cerebrovascular circulation;
tomography,X-ray computed
- From:
Chinese Journal of Medical Imaging Technology
2025;41(7):1085-1090
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the value of whole-brain CT perfusion(CTP)parameters at different time and clinical data for predicting delayed cerebral ischemia(DCI)and 3-month poor prognosis in patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods Totally 127 aSAH patients were retrospectively enrolled.Clinical and CTP data within 24 h of symptom onset and during DCI time window(DCITW)were collected.The patients were divided into DCI group(n=34)and non-DCI group(n=93)based on DCI occurred or not during hospitalization,also into poor outcome group(modified Rankin scale[mRS]≥3,n=36)and good outcome group(mRS≤2)based on 3-month's follow-up.Multivariate logistic regression was performed to select independent predictive factors among variates being significantly different between groups.Then receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the predictive performance of logistic regression model.Results Patients'age,modified Fisher score(mFS),subarachnoid hemorrhage early brain edema score(SEBES)and mean flow extraction product(mFEP)within 24 h of onset were all identified as independent predictive factors of DCI,and the AUC of their combination for predicting DCI during hospitalization was 0.817.Patients' age and mFS within 24 h of onset,alternatively,World Federation of Neurosurgical Societies(WFNS)grade and mFEP during DCITW were all independent predictive predictors of 3 months' prognosis,and the combination of the latter two showed better predictive performance(AUC=0.922)tahn the former two(AUC=0.822,P＜0.05).Conclusion Whole-brain CTP parameters combined with clinical data within 24 h of onset of aSAH could be used to predict the occurrence of DCI during hospitalization,whole-brain CTP parameters during DCITW could be used to predict 3 months'poor prognosis.
