Objective quantification of perfusion-weighted computed tomography in the setting of acute aneurysmal subarachnoid hemorrhage

Abstract

Perfusion-weighted computed tomography (CTP) is a relatively recent innovation that estimates a value for cerebral blood flow (CBF) using a series of axial head CT images which tracks the time course of signal from an administered bolus of intravenous contrast. We introduce a novel computer-based method for objective quantification of CBF values calculated from CTP images. Our method corrects for the inherent variability of the CTP methodology seen in the subarachnoid hemorrhage (SAH) patient population to potentially aid in the diagnosis of cerebral vasospasm (CVS). This method analyzes and quantifies side-to-side asymmetry of CBF and represents relative differences in a construct termed a relative difference map (RDM). Herein, we present our preliminary results that show that analysis of histograms of the RDM in left and right hemispheres, as well as different vascular territories of the brain, can be used for detection and diagnosis of cerebral vasospasm in patients with SAH. While this method has been designed specifically to analyze postprocessed CTP images, it could be potentially applied to quantification and analysis of MR perfusion data, as well.