title: Assessment of perihematomal hypoperfusion injury in subacute and chronic intracerebral hemorrhage by CT perfusion imaging.
abstract: OBJECTIVE
  To study alterations of perihematomal cerebral perfusion associated to subacute and chronic intracerebral hemorrhage (ICH) by means of computed tomography perfusion (CTP) imaging.
  
  
  METHODS
  Non-enhanced CT scan and CTP examination were performed in 12 patients with subacute and chronic supratentorial ICH. The hematoma volume was measured, and the regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV), mean transit time (MTT) and time-to-peak (TTP) adjacent to hematoma were measured in 11 of 12 cases.
  
  
  RESULTS
  Eleven patients with mean age of 58.1 years were finally analysed. Mean time interval from symptom onset to initial CTP scanning was 18.4 days; mean hematoma volume was 26.8 ml. The gradient of hypoperfusion around the hematoma was revealed by rCBF maps in 11 cases, and by rCBV maps in ten cases. The areas of delayed TTP and MTT were showed in 11 and ten cases, respectively. The degree of reduction in rCBV correlated strongly with the hematoma volume (r(inner)=0.764, p=0.006;r(outer)=0.703, p=0.016). There was no correlation between the changes in rCBF, rCBV, MTT and TTP and the time interval from symptom onset to initial CTP examination.
  
  
  CONCLUSIONS
  We have concluded that the gradient of hypoperfusion surrounding the hematoma may still exist during the subacute and chronic phases after ICH. The alterations in rCBV correlate with the hematoma volume. We believe that the reperfusion injury marked by increased rCBV contributes to the perilesional brain injury. The quantitative CT perfusion measurements can provide valuable information in individual management and prognostic evaluation of ICH.
authors: Neuroimaging Center, Beijing Tiantan Hospital, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China.
authors: Jian
authors: J
authors: Zhou
authors: Hongmei
authors: H
authors: Zhang
authors: Peiyi
authors: P
authors: Gao
authors: Yan
authors: Y
authors: Lin
authors: Xiaoguang
authors: X
authors: Li
mesh_terms: D000328:Adult; D000368:Aged; D001931:Brain Mapping; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017711:Nonlinear Dynamics; D010477:Perfusion / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*