CTPI评价亚急性期脑出血后周围组织的血流动力学变化

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Abstract Objective: To study the perihematomal hemodynamics changes in patients with subacute hypertensive intracerebral hemorrhage using 320-row volume CT perfusion imaging. Methods: CTPI was performed in twenty-one patients from 4 days to 14 days after the onset of HICH. The volume of the hematomas was measured, and the perfusion parameter values of the marginal zone and outer zone of the intracerebral hematoma and contralateral mirror were measured, including cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT) and time-to-peak (TTP), and rCBF, rCBV, rMTT and rTTP were calculated by ipsilateral/contralateral value. The differences of perfusion parameter values between the marginal zone or the outer zone and the mirror area, and the differences of relative perfusion parameters values between marginal and outer zone were analyzed by paired samples t test. Relationships between the volume of hematomas and the time from the onset to the CTPI performance and rCBF, rCBV, rMTT and rTTP of marginal and outer area were analyzed by Pearson correlation analysis. Results: ①Compared with the mirror area, the CBF and CBV of the marginal zone showed lower perfusion and there was significant statistical difference (tCBF=-4.442, PCBF<0.01; tCBF=-4.139, PCBV<0.01), the TTP was more delayed in the marginal zone, and there was significant statistical difference (tTTP=4.030, PTTP<0.01), and the MTT of marginal zone was shorter but there was no significant statistical difference (tMTT=-1.631, PMTT>0.05); The CBF of the outer zone presented lower perfusion than the mirror area and there was significant statistical difference (tCBF=-2.196, PCBF<0.05), MTT was longer than that of the mirror area, there was significant statistical difference (tMTT=-2.093, PMTT<0.05), and there was no statistically difference between the CBV or TTP of outer and mirror area (tCBV=-0.776, PCBV>0.05 and tTTP=0.336, PTTP>0.05). The rCBF and rCBV in the marginal zone were lower than those in the outer zone, and there was significant statistical difference (trCBF=-2.688, PrCBF<0.05 and trCBV=-3.124, PrCBV<0.01 respectively). rMTT was significantly shorter (trMTT=-2.770, PrMTT<0.05) than it in the outer zone, but rTTP was more delayed in the marginal zone (trTTP=3.574, PrTTP<0.01). ②There was no significant relationship between the volume of subacute hematomas and rCBF, rCBV, rMTT of the marginal zone and the outer zone or rTTP of the outer zone, and there was significant relationship between that and rTTP of the marginal zone. There was also no significant relationship between the time from onset to the CTPI performance and rCBF, rCBV, rMTT of the marginal zone or the outer zone and rTTP of the marginal zone, and there was significant relationship between that and rTTP of the outer zone (r=0.441, P<0.05). Conclusion: Hypoperfusion still remained in perihematomal region of subacute hypertensive intracerebral hematoma, furthermore there is no significant correlation between rCBF and rCBV of perihematoma and the volume of hematoma and the time from onset to CPTI performance.

Key words： intracerebral hemorrhage subacute tomography, X-ray computed perfusion

Received: 26 January 2015

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2015/V45/I10 /753

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