Dynamic Volume Computed Tomography Perfusion Imaging In Evaluation Of Secondary Ischemia After Acute Cerebral Hemorrhage

This study aims to investigate the use of 320-slice volume computed tomography perfusion imaging (VCTPI) for evaluation of secondary cerebral ischemia after acute supratentorial spontaneous cerebral hematoma. VCTPI data of 33 patients with acute supratentorial spontaneous cerebral hematoma were retrospectively analyzed. Perfusion parameters in affected tissues, surrounding tissues, and corresponding contralateral mirror image zones were analyzed, and ipsilateral/contralateral relative values were calculated for each parameter. The paired t test was used to compare the differences among the parameters. The perfusion in the affected regions was reduced in comparison to the mirror image regions, and differences in cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), and time-to-peak (TTP) were all statistically significant. CBF and TTP in ipsilateral non-affected areas were significantly lower than that in the contralateral mirror image regions, but the differences in CBV and MTT between sides were not significant. There were visible perfusion asymmetries between the cerebellar hemispheres in 10 of 33 patients (30%), 8 of whom exhibited reduced perfusion in the hematoma-contralateral cerebellum and 2 of whom exhibited reduced perfusion in the hematoma-ipsilateral cerebellum. The tissues surrounding acute supratentorial spontaneous cerebral hematoma were hypoperfused. VCTPI not only displayed secondary cerebral ischemia around the hematoma, but also revealed changes distant to the primary lesion, thus achieving a comprehensive assessment of post-hemorrhagic cerebral perfusion.