뇌동맥류성 자발성 지주막하출혈환자에서의 경두개 도플러 검사와 관류 뇌전산화단층촬영의 비교

Object : This study is designed to estimate the clinical usefulness of perfusion computed tomography (perfusion CT) as an easily accessible tool to evaluate cerebral blood flow (CBF) in patients with aneurysmal subarachnoid hemorrhage. Method : Twenty patients with aneurysmal spontaneous subarachnoid hemorrhage who underwent either aneurysmal neck clipping or interventional coil embolization and who also had taken transcranial doppler study and perfusion CT were included as study group. And as a control group, fifteen patients without neurologic deficit were studied with the same devices. We compared the cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) from obtained perfusion CT with the results of transcranial doppler and clinical course. Results: CBF parameters of perfusion CT in control group showed close accordance with those values of reported xenon CT and positron emission tomography data. In doppler study, the blood flow velocity was higher in cases with vasospasm than without it (p=0.027). There showed significant relationship between vasospasm and perfusion CT parameters, as decrease in CBF (p=0.061) and increase in MTT (p=0.013). Perfusion CT parameters were closely correlated with TCD parameters in clinical vasospasm as reverse correlation in CBF (R²=0.45) and positive in MIT (R²=0.58). Conclusion : The cerebral blood flow parameters of Perfusion CT showed reliable and accurate values in control group. The perfusion CT and TCD can be used as easily accessible non-invasive tools to evaluate cerebral blood flow parameters in clinical settings of patients with aneurysmal subarachnoid hemorrhage. (Kor J Cerebrovascular Surgery 7:48- 53, 2005)