Sobesky Jan, von Kummer Rüdiger, Frackowiak Monika, Zaro Weber Olivier, Lehnhardt Fritz G, Dohmen Christian, Neveling Michael, Möller-Hartmann Walter, Jacobs Andreas H, Heiss Wolf-Dieter
Department of Neurology, University of Cologne, Cologne, Germany.
Cerebrovasc Dis. 2006;21(5-6):336-9. doi: 10.1159/000091539. Epub 2006 Feb 14.
Brain tissue hypoattenuation on early computed tomography is frequently included in decision making in acute stroke management. However, its pathophysiological counterpart needs further evaluation.
By comparative imaging with diffusion-weighted imaging and 15O-water positron emission tomography we aimed to interpret early (<6 h) hypoattenuation.
In 11 patients, the hypoattenuation corresponded to a decreased proton diffusion (median 115.9% relative DWI value) measured by magnetic resonance imaging and to a severe hypoperfusion (below 12 ml/100 g/ min) assessed by positron emission tomography. The volume of parenchymal hypoattenuation correlated to the tissue with disturbed diffusion (Spearman's rho=0.73), but largely underestimated the hypoperfusion below 20 ml/100 g/min.
Early hypoattenuation reflects the coupling of the severity of ischemia and resulting diffusion changes. It allows an estimate of the infarct core but underestimates the penumbral hypoperfusion.
早期计算机断层扫描显示的脑组织低密度影常被纳入急性卒中治疗的决策过程中。然而，其对应的病理生理学机制仍需进一步评估。
通过与扩散加权成像和15O-水正电子发射断层扫描进行对比成像，我们旨在解读早期（<6小时）低密度影。
在11例患者中，低密度影对应磁共振成像测量的质子扩散降低（相对扩散加权成像值中位数为115.9%）以及正电子发射断层扫描评估的严重灌注不足（低于12毫升/100克/分钟）。实质低密度影的体积与扩散异常的组织相关（斯皮尔曼相关系数ρ=0.73），但在很大程度上低估了低于20毫升/100克/分钟的灌注不足情况。
早期低密度影反映了缺血严重程度与由此导致的扩散变化之间的关联。它能够对梗死核心进行估计，但低估了半暗带的灌注不足情况。
