Correlation of the Beta-trace protein and inflammatory cytokines with magnetic resonance imaging in chronic subdural hematomas : a prospective study.
OBJECTIVE
Magnetic resonance imaging (MRI) of chronic subdural hematoma (CSDH) detects various patterns, which can be attributed to many factors. The purpose of this study was to measure the level of interleukin-6 (IL-6), interleukin-8 (IL-8), and highly specific protein [beta-trace protein (βTP)] for cerebrospinal fluid (CSF) in CSDHs, and correlate the levels of these markers with the MRI findings.


METHODS
Thirty one patients, treated surgically for CSDH, were divided on the basis of MRI findings into hyperintense and non-hyperintense groups. The concentrations of IL-6, IL-8, and βTP in the subdural fluid and serum were measured. The βTP was considered to indicate an admixture of CSF to the subdural fluid if βTP in the subdural fluid (βTPSF)/βTP in the serum (βTPSER)>2.


RESULTS
The mean concentrations of IL-6 and IL-8 of the hyperintense group (n=17) of T1-WI MRI were 3975.1±1040.8 pg/mL and 6873.2±6365.4 pg/mL, whereas them of the non-hyperintense group (n=14) were 2173.5±1042.1 pg/mL and 2851.2±6267.5 pg/mL (p<0.001 and p=0.004). The mean concentrations of βTPSF and the ratio of βTPSF/βTPSER of the hyperintense group (n=13) of T2-WI MRI were 7.3±2.9 mg/L and 12.6±5.4, whereas them of the non-hyperintense group (n=18) were 4.3±2.3 mg/L and 7.5±3.9 (p=0.011 and p=0.011).


CONCLUSIONS
The hyperintense group on T1-WI MRI of CSDHs exhibited higher concentrations of IL-6 and IL-8 than non-hyperintense group. And, the hyperintese group on T2-WI MRI exhibited higher concentrations of βTPSF and the ratio of βTPSF/βTPSER than non-hyperintense group. These findings appear to be associated with rebleeding and CSF admixture in the CSDHs.
Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea.
Ki-Su
KS
Park
Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea.
Seong-Hyun
SH
Park
Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea.
Sung-Kyoo
SK
Hwang
Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea.
Chaekyung
C
Kim
Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea.
Jeong-Hyun
JH
Hwang
Beta-trace protein; Chronic subdural hematoma; Interleukin; Magnetic resonance imaging