{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T01:10:52Z","timestamp":1790471452060,"version":"4.1.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,1,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Vasospasm is a treatable cause of deterioration following aneurysmal subarachnoid hemorrhage. Cerebral computed tomography perfusion mean transit times have been proposed as a predictor of vasospasm but suffer from well\u2010known technical limitations. We evaluated fully automated, thresholded time\u2010to\u2010maxima of the tissue residue function (\n              <jats:italic>T<\/jats:italic>\n              <jats:sub>max<\/jats:sub>\n              ) for determination of vasospasm following aneurysmal subarachnoid hemorrhage.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Retrospective analysis of 540 arterial segments from 36 encounters in 31 consecutive patients with aneurysmal subarachnoid hemorrhage undergoing computed tomography angiography (CTA), computed tomography perfusion, and digital subtraction angiography (DSA) within 24\u00a0hours.\n              <jats:italic>T<\/jats:italic>\n              <jats:sub>max<\/jats:sub>\n              at 4, 6, 8, and 10\u00a0s was generated using RAPID (iSchemaView Inc., Menlo Park, CA). Dual\u2010reader CTA and computed tomography perfusion interpretations were compared for patients with and without vasospasm on DSA (DSA+ and DSA\u2212). Logistic regression models were developed using CTA and\n              <jats:italic>T<\/jats:italic>\n              <jats:sub>max<\/jats:sub>\n              as input predictors and DSA vasospasm as outcome in adjusted and unadjusted models. Imaging studies from all 31 subjects (mean age 47.3\u00b111.1, 77% female, 65% with single aneurysm with mean size of 6.0\u00b12.9\u00a0mm) were included. Vasospasm was identified in 42 segments on DSA and 59 segments on CTA, with significant associations across individual vessel segments (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). In adjusted analyses, DSA vasospasm was associated with CTA (odds ratio [OR], 2.43; 95% CI, 0.94\u20136.32;\n              <jats:italic>P<\/jats:italic>\n              =0.068) as well as territory\u2010specific\n              <jats:italic>T<\/jats:italic>\n              <jats:sub>max<\/jats:sub>\n              &gt;6\u00a0seconds delays (OR, 3.57; 95% CI, 1.36\u20139.35;\n              <jats:italic>P<\/jats:italic>\n              =0.009). Sensitivity\/specificity for DSA vasospasm was 31%\/91% for CTA, 26%\/89% for\n              <jats:italic>T<\/jats:italic>\n              <jats:sub>max<\/jats:sub>\n              &gt;6\u00a0seconds, and 12%\/99% for CTA+\n              <jats:italic>T<\/jats:italic>\n              <jats:sub>max<\/jats:sub>\n              &gt;6\u00a0seconds.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              CTA and\n              <jats:italic>T<\/jats:italic>\n              <jats:sub>max<\/jats:sub>\n              offer high specificity for presence of vasospasm; their utility, even in combination, as screening tests is, however, limited by poor sensitivity.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.023828","type":"journal-article","created":{"date-parts":[[2021,12,31]],"date-time":"2021-12-31T11:36:03Z","timestamp":1640950563000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Diagnostic Performance of Computed Tomography Angiography and Computed Tomography Perfusion Tissue Time\u2010to\u2010Maximum in Vasospasm Following Aneurysmal Subarachnoid Hemorrhage"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5274-1105","authenticated-orcid":false,"given":"Jason W.","family":"Allen","sequence":"first","affiliation":[{"name":"Department of Radiology and Imaging Sciences Emory University Atlanta GA"},{"name":"Department of Neurology Emory University Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Prater","sequence":"additional","affiliation":[{"name":"Department of Radiology and Imaging Sciences Emory University Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Kallas","sequence":"additional","affiliation":[{"name":"Department of Radiology and Imaging Sciences Emory University Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed A.","family":"Abidi","sequence":"additional","affiliation":[{"name":"Emory School of Medicine Emory University Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian M.","family":"Howard","sequence":"additional","affiliation":[{"name":"Department of Radiology and Imaging Sciences Emory University Atlanta GA"},{"name":"Department of Neurosurgery Emory University Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Tong","sequence":"additional","affiliation":[{"name":"Department of Radiology and Imaging Sciences Emory University Atlanta GA"},{"name":"Department of Neurosurgery Emory University Atlanta GA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5097-416X","authenticated-orcid":false,"given":"Shashank","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Neurology New York University New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0031-1004","authenticated-orcid":false,"given":"Shadi","family":"Yaghi","sequence":"additional","affiliation":[{"name":"Department of Neurology Brown University Providence RI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3141-1094","authenticated-orcid":false,"given":"Seena","family":"Dehkharghani","sequence":"additional","affiliation":[{"name":"Department of Neurology New York University New York NY"},{"name":"Department of Radiology New York University New York NY"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra052732"},{"key":"e_1_3_2_3_2","first-page":"26","article-title":"Vasospasm after subarachnoid hemorrhage: utility of perfusion CT and CT angiography on diagnosis and management","volume":"27","author":"Wintermark M","year":"2006","unstructured":"Wintermark M, Ko NU, Smith WS, Liu S, Higashida RT, Dillon WP. 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