Early evaluation of CT perfusion in cerebral contusion and laceration: an initial study

YUAN Tao; QUAN Guan-min; ZHONG Hong-bo; LIU Huai-jun; WANG Ying-jie; QI Zhan-yuan; WEI Zhi-gang

Journal of China Clinic Medical Imaging ›› 2010, Vol. 21 ›› Issue (11) : 765-769.

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Early evaluation of CT perfusion in cerebral contusion and laceration: an initial study

YUAN Tao1, QUAN Guan-min1, ZHONG Hong-bo2, LIU Huai-jun1, WANG Ying-jie1, QI Zhan-yuan3, WEI Zhi-gang1

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Abstract

Objective: To probe the alteration of cerebral blood flow(CBF), cerebral blood volume(CBV) and mean transit time(MTT) of cerebral contusion and laceration with CT perfusion(CTP) within 48 hours after closed traumatic brain injury(TBI). And to investigate the value of CTP on predicting the lesion size on non-contrast CT(NCCT) one week later. Methods: NCCT and CTP were performed in 18 patients suffering from cerebral contusion and laceration within 48 hours after TBI. NCCT was repeatedly made 1 week thereafter. CBF, CBV and MTT were measured in three different regions: the hemorrhagic area, the surrounding hypodense region, and the perilesional normal-appearing parenchyma. All these parameters of the mirror region of contralateral hemisphere were also recorded. The area with abnormal density or abnormal color on initial NCCT and CBF-, CBV-, and MTT-derived maps were measured and compared with the area measured on the same slice on NCCT 1 week later. Results: The CBF and CBV of hemorrhagic areas and its surrounding hypodense region of cerebral contusion and laceration decreased obviously[the CBF were (2.42±1.62)ml/(100g·min) and (10.58±6.45)ml/(100g·min) separately and the CBV were (0.62±0.41)ml/100g and (1.53±0.47)ml/100g respectively]. The CBF and CBV parameters of hypodense region were more variable. MTT of hemorrhagic area and its surrounding hypodense region were prolonged predominantly[(16.10±8.45)s and (9.69±6.31)s separately]. The whole area of cerebral contusion and laceration showed noticeably enlarged during the first week after trauma. In comparison with the initial NCCT and MTT map, CBF and CBV maps were proved to be more congruent with the findings of NCCT at 1 week(66.67% and 50% respectively). According to initial NCCT and MTT maps, the area of lesions were more often underestimated compared to the follow-up CT(77.78% and 72.22% respectively). Conclusions: The perfusion of cerebral contusion and laceration decreased obviously, with pronounced alteration on CBF and CBV at the hemorrhagic regions. The paramaters of CBF and CBV were more variable than those of other areas. This study suggested that CBF and CBV maps could be more accurate for early predicting the area of lesions 1 week after TBI.

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Brain injuries / Tomography / X-ray computed

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YUAN Tao;QUAN Guan-min;ZHONG Hong-bo;LIU Huai-jun;WANG Ying-jie;QI Zhan-yuan;WEI Zhi-gang. Early evaluation of CT perfusion in cerebral contusion and laceration: an initial study[J]. Journal of China Clinic Medical Imaging. 2010, 21(11): 765-769