CT perfusion is a valuable tool for evaluating cerebrovascular diseases, but its role in patients with hypoxic ischaemic encephalopathy is unclear. This study aimed to investigate 1) the patterns of cerebral perfusion changes that may occur early on after successful resuscitation, and 2) their correlation with clinical outcome to explore their value for predicting outcome. We conducted a retrospective analysis of perfusion maps from patients who underwent CT brain perfusion within 12 h following successful resuscitation. We classified the perfusion changes into distinct patterns. According to the cerebral performance category (CPC) score clinical outcome was categorised as favourable (CPC 1–2), or unfavourable (CPC 3–5). A total of 87 patients were included of whom 33 had a favourable outcome (60.6% male, mean age 60 ± 16 years), whereas 54 exhibited an unfavourable outcome (59.3% male, mean age 60 ± 19 years). Of the patients in the favourable outcome group, 30.3% showed no characteristic perfusion changes, in contrast to the unfavourable outcome group where all patients exhibit changes in perfusion. Eighteen perfusion patterns were identified. The most significant patterns for prediction of unfavourable outcome in terms of their high specificity and frequency were hypoperfusion of the brainstem as well as coexisting hypoperfusion of the brainstem and thalamus. This pilot study identified various perfusion patterns in patients after resuscitation, indicative of circulatory changes associated with post-cardiac-arrest brain injury. After validation, certain patterns could potentially be used in conjunction with other prognostic markers for stratifying patients and adjusting personalized treatment following cardiopulmonary resuscitation. Normal brain perfusion within 12 h after resuscitation is predictive of favourable outcome with high specificity.

中文翻译：

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成功心肺复苏后 CT 脑灌注模式和临床结果：一项试点研究

CT灌注是评估脑血管疾病的重要工具，但其在缺氧缺血性脑病患者中的作用尚不清楚。本研究旨在调查 1) 成功复苏后早期可能发生的脑灌注变化模式，2) 它们与临床结果的相关性，以探索其预测结果的价值。我们对成功复苏后 12 小时内接受 CT 脑灌注的患者的灌注图进行了回顾性分析。我们将灌注变化分为不同的模式。根据大脑性能类别 (CPC) 评分，临床结果分为有利 (CPC 1-2) 或不利 (CPC 3-5)。总共纳入 87 名患者，其中 33 名患者具有良好的结果（60.6% 为男性，平均年龄 60 ± 16 岁），而 54 名患者表现出不良结果（59.3% 为男性，平均年龄 60 ± 19 岁）。在有利结果组中，30.3% 的患者没有表现出特征性灌注变化，而不利结果组中所有患者均表现出灌注变化。确定了十八种灌注模式。就其高特异性和频率而言，预测不良结果的最重要模式是脑干低灌注以及脑干和丘脑共存低灌注。这项初步研究确定了患者复苏后的各种灌注模式，表明与心脏骤停后脑损伤相关的循环变化。经过验证后，某些模式可能会与其他预后标志物结合使用，对患者进行分层并调整心肺复苏后的个性化治疗。复苏后 12 小时内正常的脑灌注可预测良好的结果，具有高度特异性。