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<meta name="HW.identifier" content="/ajnr/32/10/1879.atom" />
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<meta name="DC.Language" content="en" />
<meta name="DC.Title" content="Early Rate of Contrast Extravasation in Patients with Intracerebral Hemorrhage" />
<meta name="DC.Identifier" content="10.3174/ajnr.A2669" />
<meta name="DC.Date" content="2011-11-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2011 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="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 &lt; .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.

CBF
:   cerebral blood flow
CBV
:   cerebral blood volume
CTA
:   CT angiography
ICH
:   intracerebral hemorrhage
IVH
:   intraventricular hemorrhage
NCCT
:   non-contrast CT
NIHSS
:   National Institutes of Health Stroke Scale
PCCT
:   post–contrast-enhanced CT
PCL
:   postcontrast leakage
PCT
:   perfusion CT
PS
:   permeability surface area product
PWI
:   perfusion-weighted imaging" />
<meta name="DC.Contributor" content="C.D. d'Esterre" />
<meta name="DC.Contributor" content="T.L. Chia" />
<meta name="DC.Contributor" content="A. Jairath" />
<meta name="DC.Contributor" content="T.Y. Lee" />
<meta name="DC.Contributor" content="S.P. Symons" />
<meta name="DC.Contributor" content="R.I. Aviv" />
<meta name="article:published_time" content="2011-11-01" />
<meta name="article:section" content="Brain" />
<meta name="citation_title" content="Early Rate of Contrast Extravasation in Patients with Intracerebral Hemorrhage" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;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.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;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.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;PS was 6.5 ± 1.60 mL · min&lt;sup&gt;−1&lt;/sup&gt; × (100 g)&lt;sup&gt;−1&lt;/sup&gt;, 0.95 ± 0.39 mL · min&lt;sup&gt;−1&lt;/sup&gt; × (100 g)&lt;sup&gt;−1&lt;/sup&gt;, 0.12 ± 0.39 mL · min&lt;sup&gt;−1&lt;/sup&gt; × (100 g)&lt;sup&gt;−1&lt;/sup&gt;, 0.26 ± 0.09 mL · min&lt;sup&gt;−1&lt;/sup&gt; × (100 g)&lt;sup&gt;−1&lt;/sup&gt;, 0.38 ± 0.26 mL · min&lt;sup&gt;−1&lt;/sup&gt; × (100 g)&lt;sup&gt;−1&lt;/sup&gt;, and 0.09 ± 0.32 mL · min&lt;sup&gt;−1&lt;/sup&gt; × (100 g)&lt;sup&gt;−1&lt;/sup&gt; 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 &lt;i&gt;(P&lt;/i&gt; &amp;lt; .05&lt;i&gt;)&lt;/i&gt;. 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.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;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.&lt;/p&gt;" />
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<meta name="twitter:title" content="Early Rate of Contrast Extravasation in Patients with Intracerebral Hemorrhage" />
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<meta name="twitter:image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/32/10.cover.gif" />
<meta name="twitter:description" content="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 &lt; .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.

CBF
:   cerebral blood flow
CBV
:   cerebral blood volume
CTA
:   CT angiography
ICH
:   intracerebral hemorrhage
IVH
:   intraventricular hemorrhage
NCCT
:   non-contrast CT
NIHSS
:   National Institutes of Health Stroke Scale
PCCT
:   post–contrast-enhanced CT
PCL
:   postcontrast leakage
PCT
:   perfusion CT
PS
:   permeability surface area product
PWI
:   perfusion-weighted imaging" />
<meta name="og-title" property="og:title" content="Early Rate of Contrast Extravasation in Patients with Intracerebral Hemorrhage" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/32/10/1879" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="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 &lt; .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.

CBF
:   cerebral blood flow
CBV
:   cerebral blood volume
CTA
:   CT angiography
ICH
:   intracerebral hemorrhage
IVH
:   intraventricular hemorrhage
NCCT
:   non-contrast CT
NIHSS
:   National Institutes of Health Stroke Scale
PCCT
:   post–contrast-enhanced CT
PCL
:   postcontrast leakage
PCT
:   perfusion CT
PS
:   permeability surface area product
PWI
:   perfusion-weighted imaging" />
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">November 2011,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">32 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1879-1884; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A2669 </span></div>
  
  
  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section ref-list" id="ref-list-1"><h2>References</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a>

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<div class="cit ref-cit ref-journal" id="cit-32.10.1879.25" data-doi="10.3174/ajnr.A2244"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Hom</span>  <span class="cit-name-given-names">J</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Dankbaar</span>  <span class="cit-name-given-names">JW</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Soares</span>  <span class="cit-name-given-names">BP</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Blood-brain barrier permeability assessed by perfusion CT predicts symptomatic hemorrhagic transformation and malignant edema in acute ischemic stroke</span>. <abbr class="cit-jnl-abbrev">AJNR Am J Neuroradiol</abbr> <span class="cit-pub-date">2011</span>;<span class="cit-vol">32</span>:<span class="cit-fpage">41</span>–<span class="cit-lpage">48</span>. <span class="cit-comment">Epub 2010 Oct 14</span></cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czo3OiIzMi8xLzQxIjtzOjQ6ImF0b20iO3M6MjE6Ii9ham5yLzMyLzEwLzE4NzkuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li><li><span class="ref-label">26.</span><a class="rev-xref-ref" href="#xref-ref-26-1" title="View reference 26. in text" id="ref-26">↵</a>

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<div class="cit ref-cit ref-journal" id="cit-32.10.1879.27" data-doi="10.3174/ajnr.A1203"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Dankbaar</span>  <span class="cit-name-given-names">JW</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Hom</span>  <span class="cit-name-given-names">J</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Schneider</span>  <span class="cit-name-given-names">T</span></span>, </li><li><span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Dynamic perfusion CT assessment of the blood-brain barrier permeability: first pass versus delayed acquisition</span>. <abbr class="cit-jnl-abbrev">AJNR Am J Neuroradiol</abbr> <span class="cit-pub-date">2008</span>;<span class="cit-vol">29</span>:<span class="cit-fpage">1671</span>–<span class="cit-lpage">76</span></cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czo5OiIyOS85LzE2NzEiO3M6NDoiYXRvbSI7czoyMToiL2FqbnIvMzIvMTAvMTg3OS5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li></ol></div></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 32</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 10 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Nov 2011 </div></div>
      
      
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      <div class="highwire-cite-title">Early Rate of Contrast Extravasation in Patients with Intracerebral Hemorrhage</div>  
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      <div class="highwire-cite-title">Early Rate of Contrast Extravasation in Patients with Intracerebral Hemorrhage</div>  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Nov 2011, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">32 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1879-1884; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2669 </span></div>
  
  
  
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