title: Influence of chronic hyperglycemia on cerebral microvascular remodeling: an in vivo study using perfusion computed tomography in acute ischemic stroke patients.
abstract: OBJECTIVE
  To investigate the effect of chronic hyperglycemia on cerebral microvascular remodeling using perfusion computed tomography.
  
  
  METHODS
  We retrospectively identified 26 patients from our registry of 2453 patients who underwent a perfusion computed tomographic study and had their hemoglobin A1c (HbA1c) measured. These 26 patients were divided into 2 groups: those with HbA1c>6.5% (n=15) and those with HbA1c≤6.5% (n=11). Perfusion computed tomographic studies were processed using a delay-corrected, deconvolution-based software. Perfusion computed tomographic values were compared between the 2 patient groups, including mean transit time, which relates to the cerebral capillary architecture and length.
  
  
  RESULTS
  Mean transit time values in the nonischemic cerebral hemisphere were significantly longer in the patients with HbA1c>6.5% (P=0.033), especially in the white matter (P=0.005). Significant correlation (R=0.469; P=0.016) between mean transit time and HbA1c level was observed.
  
  
  CONCLUSIONS
  Our results from a small sample suggest that chronic hyperglycemia may be associated with cerebral microvascular remodeling in humans. Additional prospective studies with larger sample size are required to confirm this observation.
authors.affiliation: From the Neuroradiology Division, Department of Radiology (Q.H., Y.Z., F.M., M.W.), Department of Anesthesiology (Z.Z.), and Department of Neurology (K.C.J.), University of Virginia, Charlottesville, VA; Department of Neurology, the Second Affiliated Hospital of Guangzhou Medical University, China (Q.H., Q.G.); Department of Neurology (P.M., A.E.), and Department of Radiology (M.W.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Department of Ultrasound, the Union Hospital of Huazhong University of Science and Technology, Tongji Medical College, Wuhan, China (Y.Z.); and Department of Radiology, the Tongren Hospital of Capital Medical University, Beijing, China (F.M.).
authors.forename: Qinghua
authors.initials: Q
authors.lastname: Hou
authors.forename: Zhiyi
authors.initials: Z
authors.lastname: Zuo
authors.forename: Patrik
authors.initials: P
authors.lastname: Michel
authors.forename: Yanrong
authors.initials: Y
authors.lastname: Zhang
authors.forename: Ashraf
authors.initials: A
authors.lastname: Eskandari
authors.forename: Fengyuan
authors.initials: F
authors.lastname: Man
authors.forename: Qingcun
authors.initials: Q
authors.lastname: Gao
authors.forename: Karen C
authors.initials: KC
authors.lastname: Johnston
authors.forename: Max
authors.initials: M
authors.lastname: Wintermark
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000000981:diagnostic imaging*; D002545:Brain Ischemia / Q000150:complications / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications / Q000000981:diagnostic imaging*
keywords: cerebrovascular disorders; diabetes mellitus; diabetic microangiopathy; perfusion imaging; stroke