| Title: |
Spatiotemporal dynamics of computed tomography perfusion (CTP) parameters following aneurysmal subarachnoid hemorrhage (SAH) |
| Authors: |
Szabo, Vivien; Mesnildrey, Quentin; Dargazanli, Cyril; Kucharczak, Florentin; Kobbai, Alexandre; Perrigault, Pierre-François; Chalard, Kévin |
| Contributors: |
Département d'Anesthésie-Réanimation Gui de Chauliac - CHU Montpellier; Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier)-Hôpital Gui de Chauliac CHU Montpellier; Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier); Institut de Génomique Fonctionnelle (IGF); Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM); Neuroradiologie Hôpital Gui de Chauliac; Hôpital Gui de Chauliac CHU Montpellier; Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier)-Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier); Centre Hospitalier Universitaire de Nîmes (CHU Nîmes); Image & Interaction (LIRMM; Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM); Université de Perpignan Via Domitia (UPVD)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Université de Montpellier Paul-Valéry (UMPV)-Université de Perpignan Via Domitia (UPVD)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Université de Montpellier Paul-Valéry (UMPV); Fondation Bettencourt Schueller |
| Source: |
ISSN: 0271-678X. |
| Publisher Information: |
CCSD; Nature Publishing Group |
| Publication Year: |
2026 |
| Collection: |
Inserm: HAL (Institut national de la santé et de la recherche médicale) |
| Subject Terms: |
Image processing; Perfusion imaging; Brain ischemia; Subarachnoid hemorrhage; 4D computed tomography; [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology; [INFO.INFO-IM]Computer Science [cs]/Medical Imaging; [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] |
| Description: |
International audience ; Preclinical and clinical studies suggest an early and progressive deterioration in cerebral perfusion leading to delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (SAH). Computed Tomography Perfusion (CTP) has then been investigated for DCI diagnosis and prognosis. However, spatial and temporal evolution of CTP-derived metrics have not been established, such that optimal CTP periodicity for monitoring and metrics thresholds for triggering intervention remain unclear. We developed an image processing pipeline to quantify CTP parameters' dynamics in SAH patients. Sixty-two patients were retrospectively included. Cerebral vasospasm (CVS) occurrence was 68%, that of DCI 15%. CTP parameters displayed specific dynamics in each of the noCVS, CVS, and DCI groups. In the DCI category, CBF showed early hyperemia and global flow homogenization, followed by an increased mean and variability of TMax. These features were included in a DCI predictive model (AUC = 0.94 after bootstrapping correction). Two types of dynamics emerged in DCI patients, one characterized by high asymmetry between hemispheric parameters, the other by a rapid whole-brain deterioration of brain perfusion. In conclusion, CTP parameters' early dynamics allow to sort SAH patients that will develop either CVS or DCI, advocating for repeating CTP examinations to adapt therapeutic strategies. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/40762299; PUBMED: 40762299; PUBMEDCENTRAL: PMC12325239 |
| DOI: |
10.1177/0271678X251361254 |
| Availability: |
https://hal.science/hal-05213515; https://hal.science/hal-05213515v1/document; https://hal.science/hal-05213515v1/file/Szabo%20et%20al%202025.pdf; https://doi.org/10.1177/0271678X251361254 |
| Rights: |
https://creativecommons.org/licenses/by-nc/4.0/ ; info:eu-repo/semantics/OpenAccess |
| Accession Number: |
edsbas.738041B0 |
| Database: |
BASE |