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
by Cathrin Möller
Date of Examination:2022-01-26
Date of issue:2022-01-14
Advisor:PD Dr. Daniel Behme
Referee:PD Dr. Daniel Behme
Referee:Prof. Dr. Dorothee Mielke
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Description:Dissertation
Abstract
English
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