Detection of symptomatic vasospasm after subarachnoid haemorrhage: initial findings from single time-point and serial measurements with arterial spin labelling

作者：Aoyama Kunihiro; Fushimi Yasutaka^*; Okada Tomohisa; Miyasaki Akihiro; Taki Hideaki; Shibamoto Kazunori; Togashi Kaori

来源：European Radiology, 2012, 22(11): 2382-2391.

DOI：10.1007/s00330-012-2511-5

• Arterial spin labeling
• Subarachnoid haemorrhage
• Vasospasm
• CBF
• MRI

To detect symptomatic hemispheres during the postoperative course of subarachnoid haemorrhage (SAH) using arterial spin labelling (ASL).
Eighteen patients with aneurysmal SAH were included; four exhibited symptomatic vasospasm postoperatively. All patients underwent ASL on days 9-10 (single time-point ASL). Nine patients underwent serial measurements of ASL (serial ASL) on days 1-2, 9-10 and 13-21, and seven patients also underwent imaging on days 4-7. CBF in the posterior part of the MCA territory was measured, and the ipsilateral/contralateral ratio of CBF was calculated. Differences between symptomatic hemispheres and others underwent ROC analysis.
Single time-point ASL revealed that CBFday9-10 and CBFi/c_day9-10 were significantly lower in symptomatic hemispheres than in asymptomatic hemispheres (P < 0.001). Serial ASL was significantly decreased on CBFday4-7 compared with CBFday1-2 and on CBFday9-10 compared with CBFday4-7, and significantly increased on CBFday13-21 compared with CBFday9-10. ROC analysis of single time-point ASL revealed that AUC for CBFday9-10 was 0.95, significantly higher than CBFi/c_day9-10 (P < 0.001). ROC analysis of serial ASL showed that AUC for CBFday9-10 was 0.93 and significantly higher than CBFday9-10/day1-2 and CBFi/c_day9-10 (P < 0.001).
Single time-point ASL revealed significant CBF reduction in symptomatic hemispheres compared with asymptomatic hemispheres. Serial ASL showed time-dependent CBF changes after SAH.
aEuro cent MR arterial spin labelling (ASL) can non-invasively assess cerebral blood flow (CBF)
aEuro cent ASL revealed significant CBF reduction in symptomatic hemispheres compared with asymptomatic hemispheres
aEuro cent Serial ASL measurements enable observation of time-dependent CBF changes after SAH
aEuro cent ASL is non- invasive and suitable for serial repeated examinations.

• 出版日期2012-11