{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:37:54Z","timestamp":1761824274900},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,11,2]],"date-time":"2020-11-02T00:00:00Z","timestamp":1604275200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,11,2]],"date-time":"2020-11-02T00:00:00Z","timestamp":1604275200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Cerebral vasospasm is a dreaded sequelae of aneurysmal subarachnoid hemorrhage (aSAH), requiring timely intervention with therapeutic goals of improving brain perfusion. There are currently no standardized real-time, objective assessments of the interventional procedures performed to treat vasospasm. Here we describe real-time techniques to quantify cerebral perfusion during interventional cerebral angiography. We retrospectively analyzed 39 consecutive cases performed to treat clinical vasospasm and quantified the changes in perfusion metrics between pre- and post- verapamil administrations. With Digital Subtraction Angiography (DSA) perfusion analysis, we are able to identify hypoperfused territories and quantify the exact changes in cerebral perfusion for each individual case and vascular territory. We demonstrate that perfusion analysis for DSA can be performed in real time. This provides clinicians with a colorized map which directly visualizes hypoperfused tissue, combined with associated perfusion statistics. Quantitative thresholds and analysis based on DSA perfusion may assist with real-time dosage estimation and help predict response to treatment, however future prospective analysis is required for validation.<\/jats:p>","DOI":"10.1038\/s41598-020-75365-2","type":"journal-article","created":{"date-parts":[[2020,11,2]],"date-time":"2020-11-02T11:24:59Z","timestamp":1604316299000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Computational methods for visualizing and measuring verapamil efficacy for cerebral vasospasm"],"prefix":"10.1038","volume":"10","author":[{"given":"Andrew","family":"Abumoussa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Flores","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Ho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Niethammer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deanna","family":"Sasaki-Adams","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yueh Z.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,11,2]]},"reference":[{"key":"75365_CR1","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1161\/01.STR.18.2.365","volume":"18","author":"IA Awad","year":"1987","unstructured":"Awad, I. A., Carter, L. P., Spetzler, R. F., Medina, M. & Williams, F. Jr. Clinical vasospasm after subarachnoid hemorrhage: Response to hypervolemic hemodilution and arterial hypertension. Stroke 18, 365\u2013372 (1987).","journal-title":"Stroke"},{"key":"75365_CR2","doi-asserted-by":"crossref","unstructured":"Etminan, N. Aneurysmal Subarachnoid Hemorrhage\u2014Status Quo and Perspective (2015).","DOI":"10.1007\/s12975-015-0398-6"},{"key":"75365_CR3","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1016\/j.wneu.2010.05.006","volume":"74","author":"A Alaraj","year":"2010","unstructured":"Alaraj, A. et al. Outcome following symptomatic cerebral vasospasm on presentation in aneurysmal subarachnoid hemorrhage: Coiling vs. clipping. World Neurosurg. 74, 138\u2013142 (2010).","journal-title":"World Neurosurg."},{"key":"75365_CR4","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1007\/s12028-011-9594-8","volume":"15","author":"CW Washington","year":"2011","unstructured":"Washington, C. W. et al. Detection and monitoring of vasospasm and delayed cerebral ischemia: A review and assessment of the literature. Neurocrit. Care 15, 312 (2011).","journal-title":"Neurocrit. Care"},{"key":"75365_CR5","doi-asserted-by":"publisher","first-page":"1853","DOI":"10.3174\/ajnr.A2246","volume":"31","author":"E Greenberg","year":"2010","unstructured":"Greenberg, E. et al. Diagnostic accuracy of CT angiography and CT perfusion for cerebral vasospasm: A meta-analysis. Am. J. Neuroradiol. 31, 1853\u20131860 (2010).","journal-title":"Am. J. Neuroradiol."},{"key":"75365_CR6","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1007\/BF01405268","volume":"100","author":"K-F Lindegaard","year":"1989","unstructured":"Lindegaard, K.-F., Nornes, H., Bakke, S., Sorteberg, W. & Nakstad, P. Cerebral vasospasm diagnosis by means of angiography and blood velocity measurements. Acta Neurochir. 100, 12\u201324 (1989).","journal-title":"Acta Neurochir."},{"key":"75365_CR7","first-page":"1011","volume":"21","author":"GB Anderson","year":"2000","unstructured":"Anderson, G. B., Ashforth, R., Steinke, D. E. & Findlay, J. M. CT angiography for the detection of cerebral vasospasm in patients with acute subarachnoid hemorrhage. Am. J. Neuroradiol. 21, 1011\u20131015 (2000).","journal-title":"Am. J. Neuroradiol."},{"key":"75365_CR8","doi-asserted-by":"crossref","unstructured":"Sun, H., Zhang, H., Ma, J., Liu, Y. & You, C. Evaluating the Diagnostic Accuracy of CT Perfusion in Patients with Cerebral Vasospasm after Aneurysm Rupture: A Meta-analysis. (2014).","DOI":"10.5137\/1019-5149.JTN.9914-13.1"},{"key":"75365_CR9","first-page":"1237","volume":"44","author":"YY Vora","year":"1999","unstructured":"Vora, Y. Y., Suarez-Almazor, M., Steinke, D. E., Martin, M. L. & Findlay, J. M. Role of transcranial doppler monitoring in the diagnosis of cerebral vasospasm after subarachnoid hemorrhage. Neurosurgery 44, 1237\u20131248 (1999).","journal-title":"Neurosurgery"},{"key":"75365_CR10","doi-asserted-by":"publisher","first-page":"562","DOI":"10.1161\/01.STR.16.4.562","volume":"16","author":"N Kassell","year":"1985","unstructured":"Kassell, N., Sasaki, T., Colohan, A. & Nazar, G. Cerebral vasospasm following aneurysmal subarachnoid hemorrhage. Stroke 16, 562\u2013572 (1985).","journal-title":"Stroke"},{"key":"75365_CR11","first-page":"215","volume":"42","author":"C-T Wu","year":"2004","unstructured":"Wu, C.-T., Wong, C.-S., Yeh, C.-C. & Borel, C. O. Treatment of cerebral vasospasm after subarachnoid hemorrhage\u2014A review. Acta Anaesthesiologica Taiwanica 42, 215\u2013222 (2004).","journal-title":"Acta Anaesthesiologica Taiwanica"},{"key":"75365_CR12","doi-asserted-by":"crossref","unstructured":"Scalzo, F. & Liebeskind, D. S. Perfusion angiography in acute ischemic stroke. Comput. Math. Methods Med. 2016 (2016).","DOI":"10.1155\/2016\/2478324"},{"key":"75365_CR13","doi-asserted-by":"publisher","first-page":"3333","DOI":"10.1007\/s00330-016-4702-y","volume":"27","author":"G Boulouis","year":"2017","unstructured":"Boulouis, G. et al. Treatment of cerebral vasospasm following aneurysmal subarachnoid haemorrhage: A systematic review and meta-analysis. Eur. Radiol. 27, 3333\u20133342 (2017).","journal-title":"Eur. Radiol."},{"key":"75365_CR14","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1159\/000468157","volume":"6","author":"C Donaldson","year":"2017","unstructured":"Donaldson, C. et al. Feasibility of real-time angiographic perfusion imaging in the treatment of cerebral vasospasm. Interven. Neurol. 6, 163\u2013169 (2017).","journal-title":"Interven. Neurol."},{"key":"75365_CR15","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1111\/jon.12046","volume":"24","author":"MR Levitt","year":"2014","unstructured":"Levitt, M. R. et al. Angiographic perfusion imaging: Real-time assessment of endovascular treatment for cerebral vasospasm. J. Neuroimaging 24, 387\u2013392 (2014).","journal-title":"J. Neuroimaging"},{"key":"75365_CR16","doi-asserted-by":"publisher","first-page":"2311","DOI":"10.1161\/STROKEAHA.116.013147","volume":"47","author":"F Austein","year":"2016","unstructured":"Austein, F. et al. Comparison of perfusion CT software to predict the final infarct volume after thrombectomy. Stroke 47, 2311\u20132317 (2016).","journal-title":"Stroke"},{"key":"75365_CR17","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/j.neucom.2016.01.090","volume":"197","author":"S Niu","year":"2016","unstructured":"Niu, S. et al. Low-dose cerebral perfusion computed tomography image restoration via low-rank and total variation regularizations. Neurocomputing 197, 143\u2013160 (2016).","journal-title":"Neurocomputing"},{"key":"75365_CR18","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/S0730-725X(96)00392-X","volume":"15","author":"T Benner","year":"1997","unstructured":"Benner, T., Heiland, S., Erb, G., Forsting, M. & Sartor, K. Accuracy of gamma-variate fits to concentration-time curves from dynamic susceptibility-contrast enhanced MRI: Influence of time resolution, maximal signal drop and signal-to-noise. Magn. Reson. imaging 15, 307\u2013317 (1997).","journal-title":"Magn. Reson. imaging"},{"key":"75365_CR19","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1097\/RLI.0b013e3181e1939d","volume":"45","author":"JJ Barfett","year":"2010","unstructured":"Barfett, J. J., Fierstra, J., Willems, P. W., Mikulis, D. J. & Krings, T. Intravascular functional maps of common neurovascular lesions derived from volumetric 4D CT data. Investig. Radiol. 45, 370\u2013377 (2010).","journal-title":"Investig. Radiol."},{"key":"75365_CR20","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1177\/1747493017710341","volume":"12","author":"TG Jovin","year":"2017","unstructured":"Jovin, T. G. et al. Diffusion-weighted imaging or computerized tomography perfusion assessment with clinical mismatch in the triage of wake up and late presenting strokes undergoing neurointervention with trevo (dawn) trial methods. Int. J. Stroke 12, 641\u2013652 (2017).","journal-title":"Int. J. Stroke"},{"key":"75365_CR21","first-page":"750","volume":"28","author":"S Binaghi","year":"2007","unstructured":"Binaghi, S. et al. Ct angiography and perfusion CT in cerebral vasospasm after subarachnoid hemorrhage. Am. J. Neuroradiol. 28, 750\u2013758 (2007).","journal-title":"Am. J. Neuroradiol."},{"key":"75365_CR22","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1002\/jmri.20156","volume":"20","author":"PE Summers","year":"2004","unstructured":"Summers, P. E., Kollias, S. S. & Valavanis, A. Resolution improvement in thick-slab magnetic resonance digital subtraction angiography using sense at 3t. J. Magnet. Reson. Imaging 20, 662\u2013673 (2004).","journal-title":"J. Magnet. Reson. Imaging"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-75365-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-75365-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-75365-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T22:19:20Z","timestamp":1670365160000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-75365-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,2]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,12]]}},"alternative-id":["75365"],"URL":"https:\/\/doi.org\/10.1038\/s41598-020-75365-2","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,2]]},"assertion":[{"value":"4 February 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"31 August 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 November 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"18780"}}