https://scholars.lib.ntu.edu.tw/handle/123456789/588017
標題: | Clinical application of perfusion computed tomography in neurosurgery: Clinical article | 作者: | ABEL PO-HAO HUANG JUI-CHANG TSAI LU-TING KUO CHUNG-WEI LEE HONG-SHIEE LAI LI-KAI TSAI Huang S.-J. Chen C.-M. Chen Y.-S. Chuang H.-Y. Wintermark M. |
公開日期: | 2014 | 卷: | 120 | 期: | 2 | 起(迄)頁: | 473-488 | 來源出版物: | Journal of Neurosurgery | 摘要: | Object. Currently, perfusion CT (PCT) is a valuable imaging technique that has been successfully applied to the clinical management of patients with ischemic stroke and aneurysmal subarachnoid hemorrhage (SAH). However, recent literature and the authors' experience have shown that PCT has many more important clinical applications in a variety of neurosurgical conditions. Therefore, the authors share their experiences of its application in various diseases of the cerebrovascular, neurotraumatology, and neurooncology fields and review the pertinent literature regarding expanding PCT applications for neurosurgical conditions, including pitfalls and future developments. Methods. A pertinent literature search was conducted of English-language articles describing original research, case series, and case reports from 1990 to 2011 involving PCT and with relevance and applicability to neurosurgical disorders. Results. In the cerebrovascular field, PCT is already in use as a diagnostic tool for patients suspected of having an ischemic stroke. Perfusion CT can be used to identify and define the extent of the infarct core and ischemic penumbra core, and thus aid patient selection for acute reperfusion therapy. For patients with aneurysmal SAH, PCT provides assessment of early brain injury, cerebral ischemia, and infarction, in addition to vasospasm. It may also be used to aid case selection for aggressive treatment of patients with poor SAH grade. In terms of oncological applications, PCT can be used as an imaging biomarker to assess angiogenesis and response to antiangiogenetic treatments, differentiate between glioma grades, and distinguish recurrent tumor from radiation necrosis. In the setting of traumatic brain injury, PCT can detect and delineate contusions at an early stage. In patients with mild head injury, PCT results have been shown to correlate with the severity and duration of postconcussion syndrome. In patients with moderate or severe head injury, PCT results have been shown to correlate with patients' functional outcome. Conclusions. Perfusion CT provides quantitative and qualitative data that can add diagnostic and prognostic value in a number of neurosurgical disorders, and also help with clinical decision making. With emerging new technical developments in PCT, such as characterization of blood-brain barrier permeability and whole-brain PCT, this technique is expected to provide more and more insight into the pathophysiology of many neurosurgical conditions. ?AANS, 2014. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84893307908&doi=10.3171%2f2013.10.JNS13103&partnerID=40&md5=5b95286329881a4f9b28fd8992bcdcb0 https://scholars.lib.ntu.edu.tw/handle/123456789/588017 |
ISSN: | 223085 | DOI: | 10.3171/2013.10.JNS13103 | SDG/關鍵字: | biological marker; angiogenesis; article; autoregulation; blood brain barrier; brain death; brain hemorrhage; brain infarction; brain injury; brain ischemia; brain tumor; brain vasospasm; case study; cerebrovascular disease; clinical article; computer assisted tomography; controlled study; diagnosis; disease severity; head injury; human; moyamoya disease; neurosurgery; neurotraumatology; pathophysiology; patient selection; perfusion computed tomography; postconcussion syndrome; priority journal; radiation necrosis; subarachnoid hemorrhage; traumatic brain injury; tumor recurrence; Brain Injuries; Brain Ischemia; Brain Neoplasms; Cerebral Infarction; Cerebral Revascularization; Cerebrovascular Disorders; Craniotomy; Disease Progression; Hemodynamics; Homeostasis; Humans; Intracranial Hemorrhages; Moyamoya Disease; Neurosurgery; Perfusion Imaging; Postoperative Complications; Stents; Stroke; Subarachnoid Hemorrhage; Tomography, X-Ray Computed |
顯示於: | 醫學院附設醫院 (臺大醫院) |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。