Evaluation on recent prognosis of patients with acute spontaneous hypertension and intracerebral hemorrhage with CT perfusion

Objective To evaluate the relationship between CT perfusion parameters of the perihematomal brain tissue and the recent prognosis of patients with acute spontaneous hypertensive intracerebral hemorrhage(shICH).Methods Twenty-six patients with clinically and CT diagnosed acute supratentorial shICH received CTP within 8—19 h after the onset of symptoms.At the maximum level of the hematoma,cerebral blood flow(CBF),cerebral blood volume(CBV) and mean transit time(MTT) of perihematomal area(isodense within 1cm rim of perilesion area on plain CT) and contralateral mirrored hemisphere were measured,and rCBF,rCBV,rMTT were calculated(ipsilateral/contralateral).The esults of 1-month following-up in accordance with daily living table(Barthel index,BI) by telephone were recorded.Results CBV,CBF and MTT value of perihematoma area was(1.61±1.53)ml/100 g,(16.48±12.58)ml/(100 g·min) and(9.12±2.57)s,respectively.Significantly decreased CBV,CBF and prolonged MTT in the perihematomal zone were observed against contralateral hemisphere(ZCBV=-2.603,ZCBF=-4.178,tMTT=4.747,all P0.05).Perihematomal absolute values of CBV and CBF were indicative of recent prognosis(Z=-3.40,-2.98,both P0.01),while no correlation of MTT,rCBF,rCBV,rMTT with recent prognosis was noticed(all P0.05).The area under the curve(AUC) was 0.897,0.848,respectively.Taking perihematma CBV of 1.24 ml/100 g as the threshold value,the sensitivity was 66.67% and the specificity was 100%,while taking CBF of 8.44 ml/(100 g·min) as the threshold value,the sensitivity was 100% and the specificity was 72.70%.Conclusion CTP can indicate the recent prognosis of acute shICH patients.Within a certain range,the recent prognosis declines with the increase of CBV and CBF value.