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《Chinese Journal of Medical Imaging Technology》 2008-05
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Study of perihematomal perfusion in patients with intracerebral hemorrhage with dynamic CT perfusion imaging

MA Chun, YU Cong, ZHAO Jian-nong, GUO Da-jing, LI Jie, LUO Yin-deng, XIE Wei-bo, SHEN Xia(Department of Radiology, the Second Affiliated Hospital, Chongqing Medical University, Chongqing 400010, China)  
Objective To observe perihematomal perfusion in acute and subacute intracerebral hemorrhage (ICH) in patients with hypertension with dynamic CT perfusion imaging (CTPI), and analyse prognoses of perihematomal tissue. Methods Fifteen cases with ICH were enrolled into this prospective study, non-contrast CT and dynamic CT perfusion imaging were performed respectively in acute and subacute ICH. Cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) of ipsilateral perihematoma and contralateral mirroring areas were obtained. Hypoperfusion area of hematoma and perihematoma zone in the largest axial section of hematoma were measured,and so was area surrounded by perihematomal enhancement rim in identical section with acute hematoma in subacute hematoma. Results There were significantly decreased CBF and CBV and prolonged MTT in the acute perihematomal zone against contralateral hemisphere (Z=3.124, 3.239, 2.726, respectively, P0.05). Decreased CBF in subacute perihematomal areas (against contralateral hemisphere, Z=3.408, P0.05)showed no significant difference with that in acute phase (Z=1.136, P0.05). Decreased CBV in subacute perihematomal areas (Z=2.159, P0.05) increased significantly compared with that in acute perihematomal areas (Z=1.988, P0.05). MTT prolonged than contralateral hemispere (Z=3.351, P0.05)repesented no significant difference with that in acute phase (Z=1.193, P0.05). Area of hypoperfusion in hematoma and perihematoma zone in the largest axial section of hematoma showed no significant difference with area surrounded by perihematomal enhancement rim in identical section with acute hematoma measured in subacute hematoma (Z=1.590, P0.05). Conclusion CTPI can demonstrate perihematomal hypoperfusion in patients with acute ICH. However, this condition couldn't be relieved remarkably after conservative treatment, and tissue under hypoperfusion might have outcome of necrosis at last.
【Fund】: 重庆市卫生局医学科学技术研究项目(06-2-073)资助
【CateGory Index】: R544.1;R816.1
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