Department of Neurology and Neurological Sciences, Stanford Stroke Center, Stanford University Medical Center, Palo Alto, CA 94304, USA.
Stroke. 2010 Nov;41(11):2681-3. doi: 10.1161/STROKEAHA.110.590638. Epub 2010 Oct 14.
The pathophysiology of the presumed perihematomal edema immediately surrounding an acute intracerebral hemorrhage is poorly understood, and its composition may influence clinical outcome. Method-Twenty-three patients from the Diagnostic Accuracy of MRI in Spontaneous intracerebral Hemorrhage (DASH) study were prospectively enrolled and studied with MRI. Perfusion-weighted imaging, diffusion-weighted imaging, and fluid-attenuated inversion recovery sequences were coregistered. TMax (the time when the residue function reaches its maximum) and apparent diffusion coefficient values in the presumed perihematomal edema regions of interest were compared with contralateral mirror and remote ipsilateral hemispheric regions of interest.
Compared with mirror and ipsilateral hemispheric regions of interest, TMax (the time when the residue function reaches its maximum) and apparent diffusion coefficient were consistently increased in the presumed perihematomal edema. Two thirds of the patients also exhibited patchy regions of restricted diffusion in the presumed perihematomal edema.
The MRI profile of the presumed perihematomal edema in acute intracerebral hemorrhage exhibits delayed perfusion and increased diffusivity mixed with areas of reduced diffusion.
急性脑出血周围假定的血肿周围水肿的病理生理学尚未完全了解，其成分可能影响临床结果。方法-前瞻性纳入来自 MRI 在自发性脑出血中的诊断准确性研究（DASH）的 23 名患者，并进行 MRI 研究。灌注加权成像、弥散加权成像和液体衰减反转恢复序列进行了配准。假定的血肿周围水肿感兴趣区的 TMax（残留函数达到最大值的时间）和表观弥散系数值与对侧镜像和同侧远隔半球感兴趣区进行了比较。
结果-与镜像和同侧半球感兴趣区相比，假定的血肿周围水肿中的 TMax（残留函数达到最大值的时间）和表观弥散系数持续增加。三分之二的患者在假定的血肿周围水肿中还表现出斑片状弥散受限区域。
结论-急性脑出血中假定的血肿周围水肿的 MRI 表现为灌注延迟和弥散性增加，伴有弥散减少的区域。
