脑出血患者的对比剂外渗早期速率。
Early rate of contrast extravasation in patients with intracerebral hemorrhage.
机构信息
Robarts Research Institute and Lawson Health Research Institute, University of Western Ontario, London, Canada.
出版信息
AJNR Am J Neuroradiol. 2011 Nov-Dec;32(10):1879-84. doi: 10.3174/ajnr.A2669. Epub 2011 Sep 1.
BACKGROUND AND PURPOSE
For patients with ICH, knowing the rate of CT contrast extravasation may provide insight into the pathophysiology of hematoma expansion. This study assessed whether the PCT-derived PS can measure different rates of CT contrast extravasation for admission CTA spot signs, PCCT, PCL, and regions without extravasation in patients with ICH.
MATERIALS AND METHODS
CT was performed at admission and at 24 hours for 16 patients with ICH with/without contrast extravasation seen on CTA and PCCT. PCT-PS was measured at admission. The Wilcoxon rank sum test with a Bonferroni correction was used to compare PS values from the following regions of interest: 1) spot sign lesions only (9 foci), 2) PCL lesions only (9 foci), 3) hematoma excluding extravasation, 4) regions contralateral to extravasation, 5) hematoma in patients without extravasation, and 6) an area contralateral to that in 5. Additionally, hematoma expansion was determined at 24 hours defined by NCCT.
RESULTS
PS was 6.5 ± 1.60 mL · min(-1) × (100 g)(-1), 0.95 ± 0.39 mL · min(-1) × (100 g)(-1), 0.12 ± 0.39 mL · min(-1) × (100 g)(-1), 0.26 ± 0.09 mL · min(-1) × (100 g)(-1), 0.38 ± 0.26 mL · min(-1) × (100 g)(-1), and 0.09 ± 0.32 mL · min(-1) × (100 g)(-1) for the following: 1) spot sign lesions only (9 foci), 2) PCL lesions only (9 foci), 3) hematoma excluding extravasation, 4) regions contralateral to extravasation, 5) hematoma in patients without extravasation, and 6) an area contralateral to that in 5. PS values from spot sign lesions and PCL lesions were significantly different from each other and all other regions, respectively (P < .05). Hematoma volume increased from 34.1 ± 41.0 mL to 40.2 ± 46.1 mL in extravasation-positive patients and decreased from 19.8 ± 31.8 mL to 17.4 ± 27.3 mL in extravasation-negative patients.
CONCLUSIONS
The PCT-PS parameter measures a higher rate of contrast extravasation for CTA spot sign lesions compared with PCL lesions and hematoma. Early extravasation was associated with hematoma expansion.
背景与目的
对于 ICH 患者，了解 CT 对比剂外渗率可能有助于深入了解血肿扩大的病理生理学。本研究评估了 PCT 衍生的 PS 是否可以测量 ICH 患者入院 CTA 斑点征、PCCT、PCL 和无外渗区域的不同 CT 对比剂外渗率。
材料与方法
对 16 例有/无 CTA 和 PCCT 可见对比剂外渗的 ICH 患者进行入院时和 24 小时的 CT 检查。入院时测量 PCT-PS。采用 Wilcoxon 秩和检验（Bonferroni 校正）比较以下感兴趣区域的 PS 值：1）斑点征病变仅（9 个病灶），2）PCL 病变仅（9 个病灶），3）血肿无外渗，4）外渗对侧区域，5）无外渗患者的血肿，以及 6）与 5 相反的区域。此外，通过 NCCT 确定 24 小时的血肿扩大。
结果
PS 分别为 6.5±1.60 mL·min(-1)×(100 g)(-1)、0.95±0.39 mL·min(-1)×(100 g)(-1)、0.12±0.39 mL·min(-1)×(100 g)(-1)、0.26±0.09 mL·min(-1)×(100 g)(-1)、0.38±0.26 mL·min(-1)×(100 g)(-1)和 0.09±0.32 mL·min(-1)×(100 g)(-1)，用于以下情况：1）斑点征病变仅（9 个病灶），2）PCL 病变仅（9 个病灶），3）血肿无外渗，4）外渗对侧区域，5）无外渗患者的血肿，以及 6）与 5 相反的区域。斑点征病变和 PCL 病变的 PS 值彼此之间以及与其他所有区域的 PS 值均有显著差异（P<.05）。外渗阳性患者的血肿体积从 34.1±41.0 mL 增加到 40.2±46.1 mL，而外渗阴性患者的血肿体积从 19.8±31.8 mL 减少到 17.4±27.3 mL。
结论
PCT-PS 可测量 CTA 斑点征病变与 PCL 病变和血肿相比，CT 对比剂外渗率更高。早期外渗与血肿扩大有关。
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