Objective: To discuss the hemodynamic changes in patients with acute supratentorial spontaneous intracerebral hemorrhage (within 72 hours) by using 320-slice of low-dose volume CT perfusion imaging.
Methods: Twenty-six patients of The First Affiliated Hospital of Wenzhou Medical University during December 2012 to December 2013 with acute supratentorial SICH diagnosed by plain CT scanning and clinic were enrolled. With hematoma maximum level for reference, the hematoma volume, edema area and perfusion defect area were measured, and the perfusion parameters values of the marginal area and outer area of the intracerebral hematoma and contralateral mirror area 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.
Results: The CBF, CBV of the marginal area were lower than the contralateral mirror area (tCBF=-8.125, tCBV=-8.671, PCBF, CBV<0.01); the MTT of the marginal area was shorter than the contralateral mirror area (tMTT=-3.246, PMTT<0.05); the TTP of the marginal area was longer than the contralateral mirror area (tTTP=5.027, PTTP<0.01). The CBV of the outer area was lower than the contralateral mirror area (tCBV=-2.337, PCBV<0.05); the MTT of the outer area was shorter than the contralateral mirror area (tMTT=-2.421, PMTT<0.05); the TTP of the outer area was longer than the contralateral mirror area (tTTP=2.077, PTTP<0.05). There was a siginificant relationship between the volume of acute hematoma and rCBV, rMTT, rTTP of the marginal area (rrCBV=-0.412, PrCBV<0.05, rrMTT=-0.437, PrMTT<0.05, rrTTP=0.475, PrMTT<0.05). Perihematomal CBF perfusion defect area showed a positive linear relation with the volume of acute hematoma (r=0.440, P<0.05). There was a positive linear relationship between the maximum level edema area and the hematoma volume, perihematomal CBF perfusion defect area (r=0.400, r=0.81, P<0.05).
Conclusions: 320-slice of low-dose and volume CT perfusion imaging can perfectly reflect the hemodynamic changes in brain tissuse after acute supratentorial SICH. Hypoperfusion was appeared in perihematomal area of acute supratentorial SICH. The perihematomal brain tissue may exists ischemic injury associated with the size of hematoma.The hematoma place holder effect, ischemic injury are the important cause of acute brain edema formation.