Research Of Perhenmatomal Perfusion In Hyueprtesive Intracerbral Hemorhage With CT Perfusion Imaging

Objective We do research into the perihematoma hemodynamics and its influencing factors in hypertensive intracerebral hemorrhage with CT Perfusion imaging, looking for their variation law in order to provide valuable information for the cerebral hemorrhage individual treatment and prognosis assessment.Methods This is a prospective study that 10 patients with hypertensive cerebral hemorrhage in conservative treatment were performed CT scan and CT perfusion imaging in acute stage. We made quantitative measurement of hematoma core, perihematoma within 1cm edge, 1cm outside the hematoma, cortex region of interest and the contralateral mirror area for cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time to peak (TTP) and hematoma size to compare CBF, CBV, MTT and TTP from different ROI and analysis of CBF related factors.Results We found that all the CBF, CBV, MTT and TTP seemed a steplike distribution from the center to the peripheral component hematoma:①perfusion of hematoma center defected was the most obviously;②in the area that brain edema with decreased blood flow, blood flow gradually reduce from inside to the outside; the inside perfusion were significantly lower; lateral perfusion decreased less, CBF and CBV was significantly reduced, MTT and TTP extended. The central area of hematoma, edema within the edge of 1cm, 1cm around the hematoma and the cortex outside the region, the difference between CBF and CBV was significant (all P=0.000), but the difference between MTT and TTP was not statistically significant (P=0.397, P = 0.09 ). All the CT perfusion values were involved in Wilcoxon test,mean lesion side CBF measured 36.27±33.29 was much less than the contralateral CBF (107.93±95.48), compared test significantly (P= 0.000); mean lesion side CBV measured 11.31±13.12 much less than the contralateral CBV (18.99±15.45), compared test significantly (P = 0.000); the lesion side MTT measured 20.05±25.75 was much longer than the contralateral side MTT (11.75±14.47), compared test significantly (P = 0.000); the lesion side TTP measured 9.38±4.1 was longer than contralateral side TTP (8.21±3.81), compared test significantly (P =0.000). Partial correlation analysis was used to determine the relation between CBF around the hematoma and hematoma volume, and the correlation coefficient r=-0.304, P=0.427>0.05, the difference was not statistically significant.Conclusion There were low perfusion area around the hematoma in the acute stage of hypertensive cerebral hemorrhage that prompted hypoperfusion after cerebral hemorrhage incidence of secondary brain injury, the less blood flow indicating the more severe secondary brain injury happened which will affect the recovery of damage tissue around the hematoma and the recovery of nerve function in patients. CT perfusion imaging can clearly show abnormal brain hemodynamic changes around the hematoma and more accurate detection of relevant data, provide an important observation of clinical indicators, provide strong evidence of the assessment for treatment and prognosis.