Transient Focal Increase in Perihematomal Glucose Metabolism After Acute Human Intracerebral Hemorrhage
Transient Focal Increase in Perihematomal Glucose Metabolism After Acute Human Intracerebral Hemorrhage
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DOI：
10.1161/strokeaha.108.536037
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发表时间：
2009-05-01
期刊：
影响因子：
8.3
通讯作者：
Powers, William J.
中科院分区：
文献类型：
--
作者：
Zazulia, Allyson R.;Videen, Tom O.;Powers, William J.
背景和目的-实验性脑出血（ICH）后3 - 4天内血肿周围细胞进行性死亡已有报道。我们通过在脑出血后第一周内的多个时间点用18氟脱氧葡萄糖（FDG）正电子发射断层扫描测量局部脑葡萄糖代谢的相对变化来研究人类受试者是否发生了进行性血肿周围损伤。脑出血后6.7 ± 1.6天。将5个同心环形2 mm厚血肿周围感兴趣体积（VOI）的标准化平均计数与初始研究进行比较。接下来，自动搜索与0.5至5.0毫升的球形VOIs确定最大的局灶性变化的归一化计数相比，初始study.Results-No环形或局灶性减少血肿周围FDG摄取的发展。相反，在第2次治疗中，前3个2 mm环形VOI的FDG摄取显著增加（9.2%+/- 14.2，7.8%+/- 11.3，5.9%+/- 9.0），在第3次治疗中恢复至基线水平。VOI搜索确定的病灶区域血肿周围FDG摄取增加相对于对侧控制半球在6个subjects，占环形increasing. Conclusion-perihematal葡萄糖代谢增加短暂的一个子集的患者急性ICH后2至4天。急性脑出血后大脑中葡萄糖代谢的短暂局灶性增加表明，持续数天的损伤反应正在进行中。虽然需要进一步的研究来阐明其病理生理学，但这些过程可能表明需要延长干预窗口以改善神经学结局。（中风。2009; 40：1638-1643）。
Background and Purpose-Progressive perihematomal cell death over 3 to 4 days has been described after experimental intracerebral hemorrhage (ICH). We investigated whether progressive perihematomal damage occurs in human subjects by measuring relative changes in regional cerebral glucose metabolism with (18)F-fluorordeoxyglucose (FDG) positron emission tomography at multiple time points during the first week after ICH.Methods-Thirteen subjects with a median hematoma volume of 22 cm(3) were studied 1.0 +/- 0.3, 2.9 +/- 0.8, and 6.7 +/- 1.6 days after ICH. Normalized mean counts in 5 concentric annular 2-mm-thick perihematomal volumes-of-interest (VOIs) were compared to the initial study. Next, automated searches with 0.5 to 5.0 mL spherical VOIs identified maximum focal changes in normalized counts compared to the initial study.Results-No annular or focal decrease in perihematomal FDG uptake developed. Instead, FDG uptake significantly increased at session #2 in the first 3 2-mm annular VOIs (9.2%+/- 14.2, 7.8%+/- 11.3, 5.9%+/- 9.0), returning to baseline at session #3. The VOI search identified focal regions of increased perihematomal FDG uptake relative to the contralateral control hemispheres in 6 subjects, which accounted for the annular increase.Conclusion-Perihematomal glucose metabolism increased transiently in a subset of patients 2 to 4 days after acute ICH. These transient focal increases in glucose metabolism occurring in the brain after acute ICH demonstrate that there are ongoing processes in response to injury that last for days. Although further studies are needed to elucidate their pathophysiology, these processes may be indicative of a prolonged window for intervention to improve neurological outcome. (Stroke. 2009; 40: 1638-1643.)