Title: Applied research of 320-slice low-dose volume CT perfusion imaging on secondary cerebral ischemia after acute cerebral hemorrhage
Abstract: Objective To study the diagnostic advantages and applied value of 320-slice low-dose volume CT perfusion imaging in the secondary cerebral ischemia after acute supratentorial spontaneous intracerebral hematoma formation(within 72 hours). Methods The data of one-stop 320-slice low-dose volume CT perfusion maging in 33 patients of acute supratentorial spontaneous cerebral hemorrhage of our hospital during July 2012 to December 2012 were retrospectively reviewed. The perfusion parameters values of the marginal zone and outer zone of the intracerebral hematoma and their 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 CBF, CBV, MTT and TTP between the marginal zone or the outer zone and the mirror were compared with paired samples t test. The differences of rCBF, rCBV, rMTT and rTTP between the marginal zone and the outer zone were also compared with paired samples t test. The dose-length products(DLP) were recorded during the CT scanning. Effective doses for each examination were calculated using the DLP and normalized values of effective dose per DLP appropriate for the head regions imaged. Results(1)The maximum and minimum of hematoma were 94.45 ml and 5.72 ml respectively, and the mean was 31.75 ml of 33 patients;(2)The CBF, CBV, MTT and TTP of the marginal zone were(16.83±5.89) ml?100 g)-1?min-1,(1.04±0.41)ml/100 g,(3.70±0.93)s and(20.16±3.07)s respectively and corresponding values of the mirror were(24.18±6.67)ml?(100 g)-1?min-1,(1.71±0.35)ml/100 g,(4.44±0.75)s and(17.74±3.78) s. The marginal zone showed low perfusion than the mirror area and there were significant statistical difference(tCBF=-11.223, PCBF0.01; tCBV=-11.743, PCBV0.01; tMTT=-4.641, PMTT0.01 and tTTP=5.035, PTTP0.01).(3)The CBF, CBV, MTT and TTP of the outer zone were(24.53±6.97)ml?(100 g)-1?min-1,(1.77±0.38)ml/100 g,(4.51±0.74)s and(17.98±3.49)s respectively and corresponding values of the mirror were(26.09±7.40)ml?(100 g)-1?min-1,(1.85±0.41)ml/100 g,(4.47±0.80)s and(17.63±3.58)s. There were significant statistical difference between the outer zone and the mirror area for the CBF and TTP(tCBF=-3.586, PCBF0.01 and tTTP=2.620, PTTP0.05),but there were no statistical difference for the CBV and MTT(tCBV=-2.007, PCBV0.05 and tMTT=0.662, PMTT0.05).(4)The rCBF, rCBV, rMTT and rTTP of the marginal zone were 0.70±0.14,0.61±0.20,0.84±0.17 and 1.16±0.19 respectively and corresponding values of the outer zone were 0.95±0.10,0.98±0.15,1.02±0.09 and 1.02±0.05. The perfusion of the outer zone was much better than the marginal zone. rCBF and rCBV in the marginal zone were lower(trCBF=-8.747, PrCBF0.01 and trCBV=-9.057, PrCBV0.01 respectively)and there were significant statistical difference. rMTT was shorten(trMTT=-5.639, PrMTT0.01)than the outer zone,but rTTP were more delayed in the marginal zone(trTTP=4.399, PrTTP0.01).(5)Perfusion asymmetry of bilateral cerebellar hemisphere was found in 10 patients(30%, 10/33)of total 33 patients for the naked eye. 8 patients(24%, 8/33)showed hypoperfusion in the contralateral cerebellar hemisphere of intracerebral hematoma and 2 patients(6%, 2/33) showed in the ipsilateral cerebellar hemisphere.(6)The total radiation dose of approximately 5-10 mSv for each patient in our study was significantly lower than previous studies. DLP was 4244.30 mGy for one-stop CT examination and the effective doses was 9.76 mSv.Conclusion Hypoperfusion was appeared in perihematomal area of acute supratentorial spontaneous intracerebral hematoma. 320-slice of low-dose and volume CT perfusion imaging not only revealed the secondary cerebral ischemia in perihematomal area, but also achieved whole cerebral perfusion imaging in which had a good display for changes in the distant region of the primary lesion and assessed comprehensively the intracerebral hematoma.
Publication Year: 2013
Publication Date: 2013-01-01
Language: en
Type: article
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