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Quantitative assessment on blood-brain barrier permeability of acute spontaneous intracerebral hemorrhage in basal ganglia: a CT perfusion study.
Neuroradiology. 2017 Jul; 59(7):677-684.N

Abstract

PURPOSE

Blood-brain barrier (BBB) damage aggravates perihematomal edema, and edema volume predicts prognosis independently. But the BBB permeability at the late stage of acute intracerebral hemorrhage (ICH) patients is uncertain. We aimed to assess the BBB permeability of spontaneous basal ganglia ICH using computed tomographic perfusion (CTP) and investigates its relationship with hematoma and perihematomal edema volume.

METHODS

We performed CTP on 54 consecutive ICH patients within 24 to 72 h after symptom onset. Permeability-surface area product (PS) derived from CTP imaging was measured in hematoma, "high-PS spot," perihematoma, normal-appearing, hemispheric, and contralateral regions. Hematoma and edema volumes were calculated from non-contrast CT.

RESULTS

"High-PS spot" and perihematoma regions had higher PS than the contralateral regions (p < 0.001). Hematoma PS was lower than that in the contralateral regions (p < 0.001). Perihematoma PS of the large-hematoma group was higher than that of the small-hematoma group (p = 0.011). Perihematomal edema volume correlated positively with hematoma volume (β = 0.864, p < 0.001) and perihematoma PS (β = 0.478, p < 0.001). Perihematoma PS correlated positively with hematoma volume (β = 0.373, p = 0.005).

CONCLUSIONS

Locally elevated perihematoma PS was found in most spontaneous basal ganglia ICH patients within 24 to 72 h after symptom onset. Perihematoma PS was higher in larger hematomas and was associated with larger edema volume. At this period, BBB leakage is likely to be an important factor in edema formation.

Authors+Show Affiliations

Molecular and Digital Medical Imaging Institute/Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Nanbai Xiang Street, Ouhai District, Wenzhou, Zhejiang, 325000, China.Molecular and Digital Medical Imaging Institute/Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Nanbai Xiang Street, Ouhai District, Wenzhou, Zhejiang, 325000, China.Molecular and Digital Medical Imaging Institute/Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Nanbai Xiang Street, Ouhai District, Wenzhou, Zhejiang, 325000, China.Molecular and Digital Medical Imaging Institute/Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Nanbai Xiang Street, Ouhai District, Wenzhou, Zhejiang, 325000, China.Molecular and Digital Medical Imaging Institute/Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Nanbai Xiang Street, Ouhai District, Wenzhou, Zhejiang, 325000, China.Molecular and Digital Medical Imaging Institute/Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Nanbai Xiang Street, Ouhai District, Wenzhou, Zhejiang, 325000, China.Molecular and Digital Medical Imaging Institute/Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Nanbai Xiang Street, Ouhai District, Wenzhou, Zhejiang, 325000, China.Molecular and Digital Medical Imaging Institute/Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Nanbai Xiang Street, Ouhai District, Wenzhou, Zhejiang, 325000, China.Molecular and Digital Medical Imaging Institute/Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Nanbai Xiang Street, Ouhai District, Wenzhou, Zhejiang, 325000, China.Molecular and Digital Medical Imaging Institute/Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Nanbai Xiang Street, Ouhai District, Wenzhou, Zhejiang, 325000, China.Zhenjiang Provincial Key Laboratory of Aging and Neurological Disorder Research, Department of Neurosurgery, The First Affiliated Hospital of Wenzhou Medical University, Nanbai Xiang Street, Ouhai District, Wenzhou, Zhejiang, 325000, China.GE Healthcare China, Shanghai, China. kevin_yang@ge.com.Molecular and Digital Medical Imaging Institute/Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Nanbai Xiang Street, Ouhai District, Wenzhou, Zhejiang, 325000, China. wyyycwj@163.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28580533

Citation

Xu, Haoli, et al. "Quantitative Assessment On Blood-brain Barrier Permeability of Acute Spontaneous Intracerebral Hemorrhage in Basal Ganglia: a CT Perfusion Study." Neuroradiology, vol. 59, no. 7, 2017, pp. 677-684.
Xu H, Li R, Duan Y, et al. Quantitative assessment on blood-brain barrier permeability of acute spontaneous intracerebral hemorrhage in basal ganglia: a CT perfusion study. Neuroradiology. 2017;59(7):677-684.
Xu, H., Li, R., Duan, Y., Wang, J., Liu, S., Zhang, Y., He, W., Qin, X., Cao, G., Yang, Y., Zhuge, Q., Yang, J., & Chen, W. (2017). Quantitative assessment on blood-brain barrier permeability of acute spontaneous intracerebral hemorrhage in basal ganglia: a CT perfusion study. Neuroradiology, 59(7), 677-684. https://doi.org/10.1007/s00234-017-1852-9
Xu H, et al. Quantitative Assessment On Blood-brain Barrier Permeability of Acute Spontaneous Intracerebral Hemorrhage in Basal Ganglia: a CT Perfusion Study. Neuroradiology. 2017;59(7):677-684. PubMed PMID: 28580533.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quantitative assessment on blood-brain barrier permeability of acute spontaneous intracerebral hemorrhage in basal ganglia: a CT perfusion study. AU - Xu,Haoli, AU - Li,Rui, AU - Duan,Yuxia, AU - Wang,Jincheng, AU - Liu,Shuailiang, AU - Zhang,Yue, AU - He,Wenwen, AU - Qin,Xiaotao, AU - Cao,Guoquan, AU - Yang,Yunjun, AU - Zhuge,Qichuan, AU - Yang,Jun, AU - Chen,Weijian, Y1 - 2017/06/03/ PY - 2017/02/27/received PY - 2017/05/16/accepted PY - 2017/6/6/pubmed PY - 2017/11/29/medline PY - 2017/6/6/entrez KW - Blood–brain barrier KW - Capillary permeability KW - Cerebral hemorrhage KW - Edema KW - Perfusion imaging SP - 677 EP - 684 JF - Neuroradiology JO - Neuroradiology VL - 59 IS - 7 N2 - PURPOSE: Blood-brain barrier (BBB) damage aggravates perihematomal edema, and edema volume predicts prognosis independently. But the BBB permeability at the late stage of acute intracerebral hemorrhage (ICH) patients is uncertain. We aimed to assess the BBB permeability of spontaneous basal ganglia ICH using computed tomographic perfusion (CTP) and investigates its relationship with hematoma and perihematomal edema volume. METHODS: We performed CTP on 54 consecutive ICH patients within 24 to 72 h after symptom onset. Permeability-surface area product (PS) derived from CTP imaging was measured in hematoma, "high-PS spot," perihematoma, normal-appearing, hemispheric, and contralateral regions. Hematoma and edema volumes were calculated from non-contrast CT. RESULTS: "High-PS spot" and perihematoma regions had higher PS than the contralateral regions (p < 0.001). Hematoma PS was lower than that in the contralateral regions (p < 0.001). Perihematoma PS of the large-hematoma group was higher than that of the small-hematoma group (p = 0.011). Perihematomal edema volume correlated positively with hematoma volume (β = 0.864, p < 0.001) and perihematoma PS (β = 0.478, p < 0.001). Perihematoma PS correlated positively with hematoma volume (β = 0.373, p = 0.005). CONCLUSIONS: Locally elevated perihematoma PS was found in most spontaneous basal ganglia ICH patients within 24 to 72 h after symptom onset. Perihematoma PS was higher in larger hematomas and was associated with larger edema volume. At this period, BBB leakage is likely to be an important factor in edema formation. SN - 1432-1920 UR - https://www.unboundmedicine.com/medline/citation/28580533/Quantitative_assessment_on_blood_brain_barrier_permeability_of_acute_spontaneous_intracerebral_hemorrhage_in_basal_ganglia:_a_CT_perfusion_study_ L2 - https://dx.doi.org/10.1007/s00234-017-1852-9 DB - PRIME DP - Unbound Medicine ER -