Sensitivität und Spezifität der Detektion von Vasospasmen nach SAB mittels früharterieller CTP-basierten 4D-CTA-Rekonstruktionen sowie konventioneller CTA
Sensitivity and Specificity of the Detection of Vasospasm after SAH by CTP-based 4D-CTA-Reconstruction and conventional CTA
von Cathrin Möller
Datum der mündl. Prüfung:2022-01-26
Erschienen:2022-01-14
Betreuer:PD Dr. Daniel Behme
Gutachter:PD Dr. Daniel Behme
Gutachter:Prof. Dr. Dorothee Mielke
Dateien
Name:eDiss_Detektion_von_Vasospasmen_Moeller_2022.pdf
Size:9.12Mb
Format:PDF
Description:Dissertation
Zusammenfassung
Englisch
Cerebral vasospasm frequently occur after aneurysmal subarachnoid hemorrhage (aSAH) and are a major contributor to mortality and morbidity following aSAH. Their diagnosis is a challenge which comes with a significant radiation exposure due to repeated CTA and CTP scans. In this work, I investigate the diagnostic performance of 4D-CTA reconstructed from the CTP dataset in relation to conventional CTA. I performed a retroscpective analysis of patients with aSAH who received endovascular intervention as a rescue treatment for vasospam. Considering digital subtraction angiography as gold standard, I estimated sensitivity, specificity, and interrater reliability for 4D-CTA and conventional CTA. I found no evidence that early-phase 4D-CTA performs significantly worse than conventional CTA by any characterization, and in many cases performs significantly better. This study suggests that CTA scans could be replaced by 4D-CTA reconstructed from the CTP dataset, thereby reducing radiation exposure.
Keywords: SAH; vasospasm; CTA; CTP