The Value Of CT Perfusion In The Prediction And Diagnosis Of Delayed Cerebral Ischemia In Subarachnoid Hemorrhage: Meta-analysis

Objective: To systematically evaluate the clinical value of CT perfusion(CTP)in the prediction and diagnosis of delayed cerebral ischemia(DCI)in subarachnoid hemorrhage(SAH).Methods: The databases of PubMed,Cocharane Database of systematic Rviews,Embase,CNKI,Vip,Wanfang and SinoMed were searched for studies on the relationship about CTP and DCI after SAH.And a meta-analysis was performed using software RevMan(version 5.3).Result: A total of 12 studies involing 664 patients were evaluated.The meta-analysis showed that cerebral blood flow(CBF),cerebral blood volume(CBV),mean transit time(MTT),and time-to-peak(TTP)did not differ between patients who did and did not develop DCI,On admission.In the DCI time-window(4 to 14 days after SAH),DCI was associated with a decreased CBF(MD=-12.75mL/100g/min,95%Cl:-15.85~-9.65)and an increased MTT(MD=1.44 s,95%Cl:1.16~-1.72).Conclusions: CTP can be used in the diagnosis of DCI at high incidence time window(4-14 days after bleeding),but not in the prediction of DCI.A need exists to standardize the method for measuring perfusion with CTP after SAH,and optimize and validate perfusion thresholds.