From the Department of Neurology (Y.L., H.C., N.L., W.Z.), PLA Army General Hospital, Beijing, China.
Department of Radiology (Y.L., M.W.), Neuroradiology Section, Stanford University, Stanford, California.
AJNR Am J Neuroradiol. 2017 Sep;38(9):1730-1736. doi: 10.3174/ajnr.A5287. Epub 2017 Jul 13.
The contrast volume transfer coefficient (), which reflects blood-brain barrier permeability, is influenced by circulation and measurement conditions. We hypothesized that focal low BBB permeability values can predict the spatial distribution of hemorrhagic transformation and global high BBB permeability values can predict the likelihood of hemorrhagic transformation.
We retrospectively enrolled 106 patients with hemispheric stroke who received intra-arterial thrombolytic treatment. maps were obtained with first-pass perfusion CT data. The values at the region level, obtained with the Alberta Stroke Program Early CT Score system, were compared to determine the differences between the hemorrhagic transformation and nonhemorrhagic transformation regions. The values of the whole ischemic region based on baseline perfusion CT were obtained as a variable to hemorrhagic transformation possibility at the global level.
Forty-eight (45.3%) patients had hemorrhagic transformation, and 21 (19.8%) had symptomatic intracranial hemorrhage. At the region level, there were 82 ROIs with hemorrhagic transformation and parenchymal hemorrhage with a mean , 0.5 ± 0.5/min, which was significantly lower than that in the nonhemorrhagic transformation regions ( < .01). The mean value of 615 nonhemorrhagic transformation ROIs was 0.7 ± 0.6/min. At the global level, there was a significant difference ( = .01) between the mean values of patients with symptomatic intracranial hemorrhage (1.3 ± 0.9) and those without symptomatic intracranial hemorrhage (0.8 ± 0.4). Only a high value at the global level could predict the occurrence of symptomatic intracranial hemorrhage ( < .01; OR = 5.04; 95% CI, 2.01-12.65).
Global high values can predict the likelihood of hemorrhagic transformation or symptomatic intracranial hemorrhage at the patient level, whereas focal low values can predict the spatial distributions of hemorrhagic transformation at the region level.
对比体积转移系数（）反映血脑屏障通透性，受循环和测量条件的影响。我们假设局部低 BBB 通透性值可以预测出血转化的空间分布，而全局高 BBB 通透性值可以预测出血转化的可能性。
我们回顾性纳入 106 例接受动脉内溶栓治疗的半球性卒中患者。使用首过灌注 CT 数据获得灌注图。使用 Alberta Stroke Program Early CT Score 系统获得区域水平的 值，以确定出血转化和非出血转化区域之间的差异。基于基线灌注 CT 获得整个缺血区域的 值作为全局水平出血转化可能性的变量。
48 例（45.3%）患者发生出血转化，21 例（19.8%）发生症状性颅内出血。在区域水平上，有 82 个 ROI 发生出血转化和实质血肿，平均 ，0.5 ± 0.5/min，明显低于非出血转化区域（ <.01）。615 个非出血转化 ROI 的平均 值为 0.7 ± 0.6/min。在全局水平上，症状性颅内出血患者（1.3 ± 0.9）和无症状性颅内出血患者（0.8 ± 0.4）的平均 值存在显著差异（ =.01）。只有全局高水平的高 值才能预测症状性颅内出血的发生（ <.01；OR = 5.04；95%CI，2.01-12.65）。
全局高水平的高 值可以预测患者发生出血转化或症状性颅内出血的可能性，而局部低 值可以预测出血转化的空间分布。
