Reduced CBF recovery detected by longitudinal 3D-SSP SPECT analyses predicts outcome of postoperative patients after subarachnoid haemorrhage

Tatsushi Mutoh; Tomoko Totsune; Shunsuke Takenaka; Yasuko Tatewaki; Manabu Nakagawa; Jose I. Suarez; Yasuyuki Taki; Tatsuya Ishikawa

doi:10.1111/1440-1681.12867

Reduced CBF recovery detected by longitudinal 3D-SSP SPECT analyses predicts outcome of postoperative patients after subarachnoid haemorrhage

Tatsushi Mutoh, Tomoko Totsune, Shunsuke Takenaka, Yasuko Tatewaki, Manabu Nakagawa, Jose I. Suarez, Yasuyuki Taki, Tatsuya Ishikawa

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4 Citations (Scopus)

Abstract

The aim of this study was to evaluate the impact of cerebral blood flow (CBF) recovery obtained from brain single-photon emission computed tomography (SPECT) images on postoperative outcome after aneurysmal subarachnoid haemorrhage (SAH). Twenty-nine patients who had undergone surgical clipping for ruptured anterior communicating artery aneurysms were analyzed prospectively. Routine measurements of CBF were performed using technetium-99 m hexamethyl propyleneamine oxine SPECT on days 4 and 14 after SAH. Regional voxel data analyzed by three dimensional stereotactic surface projection (3D-SSP) were compared between patients and age-matched normal database (NDB). In 3D-SSP analysis of all patients, cortical hypoperfusion around the surgical site in bilateral frontal lobes was evident on day 4 (P <.05 vs NDB), which was improved significantly on day 14. However, the recovery was less complete in patients with poor clinical grades (P <.05) and presenting symptoms attributable to delayed cerebral ischaemia (DCI) (P <.05) than those without. Multivariate analysis showed that patients with mild to moderate CBF recovery (relative Z-score differences of <4) (P =.014; odds ratio, 2.5; 95% confidence interval, 1.93–3.31) was independently associated with poor functional outcome at 3 months. We conclude that reduced CBF recovery detected by serial 3D-SSP SPECT image analyses can be a potential predictor of poor prognosis in postoperative patients after SAH.

Original language	English
Pages (from-to)	127-132
Number of pages	6
Journal	Clinical and Experimental Pharmacology and Physiology
Volume	45
Issue number	2
DOIs	https://doi.org/10.1111/1440-1681.12867
Publication status	Published - 2018 Feb

Keywords

cerebral blood flow
functional outcome
SPECT
statistical imaging analysis
subarachnoid haemorrhage

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10.1111/1440-1681.12867

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@article{78ecf4a5ab12443ca88c31278cb31df3,

title = "Reduced CBF recovery detected by longitudinal 3D-SSP SPECT analyses predicts outcome of postoperative patients after subarachnoid haemorrhage",

abstract = "The aim of this study was to evaluate the impact of cerebral blood flow (CBF) recovery obtained from brain single-photon emission computed tomography (SPECT) images on postoperative outcome after aneurysmal subarachnoid haemorrhage (SAH). Twenty-nine patients who had undergone surgical clipping for ruptured anterior communicating artery aneurysms were analyzed prospectively. Routine measurements of CBF were performed using technetium-99 m hexamethyl propyleneamine oxine SPECT on days 4 and 14 after SAH. Regional voxel data analyzed by three dimensional stereotactic surface projection (3D-SSP) were compared between patients and age-matched normal database (NDB). In 3D-SSP analysis of all patients, cortical hypoperfusion around the surgical site in bilateral frontal lobes was evident on day 4 (P <.05 vs NDB), which was improved significantly on day 14. However, the recovery was less complete in patients with poor clinical grades (P <.05) and presenting symptoms attributable to delayed cerebral ischaemia (DCI) (P <.05) than those without. Multivariate analysis showed that patients with mild to moderate CBF recovery (relative Z-score differences of <4) (P =.014; odds ratio, 2.5; 95% confidence interval, 1.93–3.31) was independently associated with poor functional outcome at 3 months. We conclude that reduced CBF recovery detected by serial 3D-SSP SPECT image analyses can be a potential predictor of poor prognosis in postoperative patients after SAH.",

keywords = "cerebral blood flow, functional outcome, SPECT, statistical imaging analysis, subarachnoid haemorrhage",

author = "Tatsushi Mutoh and Tomoko Totsune and Shunsuke Takenaka and Yasuko Tatewaki and Manabu Nakagawa and Suarez, {Jose I.} and Yasuyuki Taki and Tatsuya Ishikawa",

note = "Funding Information: Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science/ Grant Number: 15K10966; Life Science Foundation of Japan/Grant Number: H26-1. Funding Information: Funding information Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science/Grant Number: 15K10966; Life Science Foundation of Japan/Grant Number: H26-1. This study was presented in part at the 46th Critical Care Congress (Honolulu, HI, Jan 22, 2016; Abstract No.719: Research Bronze Snapshot Award). We thank the Japan Society for the Promotion of Science and Life Science Foundation of Japan. Funding Information: This study was presented in part at the 46th Critical Care Congress (Honolulu, HI, Jan 22, 2016; Abstract No.719: Research Bronze Snapshot Award). We thank the Japan Society for the Promotion of Science and Life Science Foundation of Japan. Publisher Copyright: {\textcopyright} 2017 John Wiley & Sons Australia, Ltd",

year = "2018",

month = feb,

doi = "10.1111/1440-1681.12867",

language = "English",

volume = "45",

pages = "127--132",

journal = "Clinical and Experimental Pharmacology and Physiology",

issn = "0305-1870",

publisher = "Wiley-Blackwell Publishing Ltd",

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T1 - Reduced CBF recovery detected by longitudinal 3D-SSP SPECT analyses predicts outcome of postoperative patients after subarachnoid haemorrhage

AU - Mutoh, Tatsushi

AU - Totsune, Tomoko

AU - Takenaka, Shunsuke

AU - Tatewaki, Yasuko

AU - Nakagawa, Manabu

AU - Suarez, Jose I.

AU - Taki, Yasuyuki

AU - Ishikawa, Tatsuya

N1 - Funding Information: Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science/ Grant Number: 15K10966; Life Science Foundation of Japan/Grant Number: H26-1. Funding Information: Funding information Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science/Grant Number: 15K10966; Life Science Foundation of Japan/Grant Number: H26-1. This study was presented in part at the 46th Critical Care Congress (Honolulu, HI, Jan 22, 2016; Abstract No.719: Research Bronze Snapshot Award). We thank the Japan Society for the Promotion of Science and Life Science Foundation of Japan. Funding Information: This study was presented in part at the 46th Critical Care Congress (Honolulu, HI, Jan 22, 2016; Abstract No.719: Research Bronze Snapshot Award). We thank the Japan Society for the Promotion of Science and Life Science Foundation of Japan. Publisher Copyright: © 2017 John Wiley & Sons Australia, Ltd

PY - 2018/2

Y1 - 2018/2

N2 - The aim of this study was to evaluate the impact of cerebral blood flow (CBF) recovery obtained from brain single-photon emission computed tomography (SPECT) images on postoperative outcome after aneurysmal subarachnoid haemorrhage (SAH). Twenty-nine patients who had undergone surgical clipping for ruptured anterior communicating artery aneurysms were analyzed prospectively. Routine measurements of CBF were performed using technetium-99 m hexamethyl propyleneamine oxine SPECT on days 4 and 14 after SAH. Regional voxel data analyzed by three dimensional stereotactic surface projection (3D-SSP) were compared between patients and age-matched normal database (NDB). In 3D-SSP analysis of all patients, cortical hypoperfusion around the surgical site in bilateral frontal lobes was evident on day 4 (P <.05 vs NDB), which was improved significantly on day 14. However, the recovery was less complete in patients with poor clinical grades (P <.05) and presenting symptoms attributable to delayed cerebral ischaemia (DCI) (P <.05) than those without. Multivariate analysis showed that patients with mild to moderate CBF recovery (relative Z-score differences of <4) (P =.014; odds ratio, 2.5; 95% confidence interval, 1.93–3.31) was independently associated with poor functional outcome at 3 months. We conclude that reduced CBF recovery detected by serial 3D-SSP SPECT image analyses can be a potential predictor of poor prognosis in postoperative patients after SAH.

AB - The aim of this study was to evaluate the impact of cerebral blood flow (CBF) recovery obtained from brain single-photon emission computed tomography (SPECT) images on postoperative outcome after aneurysmal subarachnoid haemorrhage (SAH). Twenty-nine patients who had undergone surgical clipping for ruptured anterior communicating artery aneurysms were analyzed prospectively. Routine measurements of CBF were performed using technetium-99 m hexamethyl propyleneamine oxine SPECT on days 4 and 14 after SAH. Regional voxel data analyzed by three dimensional stereotactic surface projection (3D-SSP) were compared between patients and age-matched normal database (NDB). In 3D-SSP analysis of all patients, cortical hypoperfusion around the surgical site in bilateral frontal lobes was evident on day 4 (P <.05 vs NDB), which was improved significantly on day 14. However, the recovery was less complete in patients with poor clinical grades (P <.05) and presenting symptoms attributable to delayed cerebral ischaemia (DCI) (P <.05) than those without. Multivariate analysis showed that patients with mild to moderate CBF recovery (relative Z-score differences of <4) (P =.014; odds ratio, 2.5; 95% confidence interval, 1.93–3.31) was independently associated with poor functional outcome at 3 months. We conclude that reduced CBF recovery detected by serial 3D-SSP SPECT image analyses can be a potential predictor of poor prognosis in postoperative patients after SAH.

KW - cerebral blood flow

KW - functional outcome

KW - SPECT

KW - statistical imaging analysis

KW - subarachnoid haemorrhage

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Reduced CBF recovery detected by longitudinal 3D-SSP SPECT analyses predicts outcome of postoperative patients after subarachnoid haemorrhage

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