Evaluation of cerebral vasospasm after aneurysmal subarachnoid hemorrhage by magnetic resonance perfusion weighted imaging

LANG Sheng-kuan; XU Hou-yin; DONG Yue-qing; MA Tie-zhu; SUN Yan; HAO Qian-qian; WANG Hui-min

doi:10.13798/j.issn.1009-153X.2016.09.002

Abstract：Objective To explore the value of magnetic resonance perfusion weighted imaging (MR-PWI) to assessment of the cerebral hemodynamics after cerebral vasospasm (CVS) in the patients with aneurysmal subarachnoid hemorrhage (aSAH). Methods There were 80 patients with CVS after aSAH in observed group. There were 20 patients with unruptured intracranial aneurysms in the control group. The cerebral digital subtraction angiography (DSA) was performed in all the patients, in whom the relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), mean transit time (MTT) and time to peak (TTP) were observed by MR-PWI. The correlationship was analyzed between CVS degree and MR PWI parameters. Results Of 80 patients in the observed group, 19 had severe CVS, 19 medial CVS, 19 mild CVS and 23 no CVS. The rCBF and rCBV were significantly lower in the cerebral regions supplied by bilateral anterior cerebral arteries (ACA) and medial cerebral arteries (MCA), and bilateral basal ganglia (BSGL) region in 19 patients with severe CVS than those in the control group. The rCBF in BSGL and rCBV in the cerebral regions supplied by ACA were significantly lower in the observed group than control group (P<0.05). TTP and MTT in the cerebral regions supplied by ACA and MCA, and BSGL region were significantly longer in the patients with severe CVS than those in the patients with medial CVS, which were significantly longer than those in the control group (P<0.05). The degree of CVS was negatively correlated with rCBV and rCBF (r<0.4), but the degree of CVS was positively correlated with TTP and MTT (0.308<r<0.744) in the above-mentioned cerebral regions. Conclusion MR-PWI examination can provide quantitative information of cerebral tissue blood perfusion, and guide the clinical diagnosis and treatment of CVS after aSAH.