Study on CT perfusion surface permeability of cerebral hemorrhage in the basal ganglia region in subacute stage

Abstract

Objective To investigate alterations of permeability of surface (PS) in subacute stage patients with intracerebral hemorrhage (ICH) using computed tomography perfusion imaging (CTPI), and analyze relationships between PS and other factors. Methods CTPI was performed in 35 patients in subacute stage (4 days-2 weeks) after onset of ICH, who were recruited in the Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University from November 2015 to June 2016. Hematoma and edema volumes were measured, and perfusion parameters of perihematoma and mirror hemisphere side of marginal zone and outer zone of hematoma, including cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), PS, and relative value (ipsilateral/contralateral) of CBF (rCBF), CBV (rCBV), MTT (rMTT) and PS (rPS), were calculated. Relationships between volumes of hematoma and edema, time from onset to CTPI performance, NIHSS scores and PS of perihematoma zone were analyzed by Pearson correlation analysis. Results The perihematoma PS ((1.87±0.48) ml·100 g-1·min-1) was higher than that in contralateral regions ((1.28±0.34) ml·100 g-1·min-1;t=-12.407, P 0.05). There were 20 patients with hematoma volume less than 10 ml and 15 patients with hematoma volume more than 10 ml, while the mean value of perihematoma PS of them showed no statistically significant difference (P>0.05). And there were no statistically significant correlations between perihematoma PS and NIHSS scores at the time of admission, CTPI examination and discharge (all P>0.05). Conclusions In subacute stage of ICH, the blood brain barrier permeability of perihematoma area is still abnormal, manifested as PS increases. The perihematoma PS positively correlates with the time of ICH onset. CTPI can accurately reflect this change, and potentially provide valuable information for evaluation and individual treatment of patients. Key words: Intracerebral hemorrhage; Tomography, X-ray computed; Perfusion; Capillary permeability; Subacute stage