Bisdas S, Hartel M, Cheong L H, Koh T S, Vogl T J
Department of Diagnostic and Interventional Radiology, Johann Wolfgang Goethe University Hospital, Theodor Stern Kai 7, 60590 Frankfurt, Germany.
J Neuroradiol. 2007 May;34(2):101-8. doi: 10.1016/j.neurad.2007.02.003.
Hemorrhagic transformation (HT) is a common consequence of infarction independent of thrombolytic therapy. Our purpose was to examine if permeability imaging in admission perfusion CT data of patients with acute stroke might indicate a subsequent HT by imaging the disrupted permeability barriers between blood and brain.
A distributed parameter model analysis of the perfusion data were used to analyze the admission perfusion surveys of eight patients with HT of the initial infarct without thrombolysis. The perfusion findings of these patients were compared with those of eight age- and gender-matched patients from the initial group that did not present with HT.
The applied statistics for comparing the ischemic voxels with the contralateral healthy tissue showed significantly higher permeability-surface product (PS), extraction ratio (E), and extracellular extravascular space volume (V(EES)) in the ischemic voxels (P range, 0.05-0.0001). In the patients without HT, the PS, E and V(EES) values in the ischemic voxels were not significantly different from those in the normal region.
Our findings indicate that early perfusion CT physiological imaging in stroke is a promising tool for identifying patients with higher risk of HT and, thus, may serve to guide therapeutic options.
出血性转化（HT）是梗死的常见后果，与溶栓治疗无关。我们的目的是通过对急性中风患者入院灌注CT数据中的通透性屏障进行成像，来研究入院灌注CT数据中的通透性成像是否可能提示随后发生的HT。
采用灌注数据的分布参数模型分析，对8例未接受溶栓治疗的初始梗死灶发生HT的患者的入院灌注检查进行分析。将这些患者的灌注结果与初始组中8例年龄和性别匹配且未出现HT的患者的灌注结果进行比较。
将缺血性体素与对侧健康组织进行比较的应用统计显示，缺血性体素中的通透性表面乘积（PS）、提取率（E）和细胞外血管外间隙体积（V(EES)）显著更高（P范围为0.05 - 0.0001）。在没有HT的患者中，缺血性体素中的PS、E和V(EES)值与正常区域的值没有显著差异。
我们的研究结果表明，中风早期灌注CT生理成像对于识别HT风险较高的患者是一种有前景的工具，因此可能有助于指导治疗选择。
