Combined With Arterial Spin Labeling And Diffusion Weighted Imaging On A Preliminary Study Of Traumatic Penumbra Zone

Objective Combined with arterial spin labeling perfusion imaging and diffusion-weighted imaging studies of focal cerebral contusion,edema and blood flow perfusion in the pericontusional zone, to determine whether the presence of the "traumatic penumbra zone", and explore its the relationship of the potential viability of tissue and discussed its formation mechanism.Methods Collecting CT diagnosis of patients hospitalized for focal cerebral contusion, and in less than 48 hours after brain trauma complete the traditional MRI, DWI, ASL scan and after discharged three months,they have completed MRI scan. By post-processing workstation showed lesions measuring DWI and ASL maximum level area, compare its size difference of the area defined as "traumatic penumbra zone". Tracking its three-month review again after traditional MRI scan and DWI, review of image on T2WI high signal area is defined as the final necrosis zone. The abnormal area of the first ASL scan displayed minus the final necrosis area is defined as the viable zone.Compare the size of penumbra zone and viable zone, and analysis of their size, whether there is a certain correlation. Combines first ASL scan and review of T2WI, DWI scans, on the first ADC maps set three regions of interest. They are located in the final necrosis zone, penumbra zone, viable zone. Each ROI area of about 50mm2. Each ROI were measured 5 times, calculating the average. When selecting regions of interest, should avoid Cerebral sulci, brain pool. Because partial volume effect of cerebrospinal fluid will affect the accuracy of the ADC values. Through statistical analysis, to determine the relationship of ADC value in penumbra zone, viable zone and final necrotic zone.Results 20 patients exhibited 23 traumatic contusions,20 of which are larger than the area of DWI lesion area ASL, the other three lesions too small to be analyzed. The average ADC value of the final necrosis, viable zone and penumbra zone were 561.7 ± 92.98 mm2/s, 1307.29 ± 194.71 mm2/s and 1343.84 ±211.17 mm2/s, respectively. The ADC value of final necrotic zone were compared with viable zone and penumbra zone, the results have statistically significant difference. The ADC values of penumbra zone were no significant differences with ADC values of viable zone. The sizes of viable zone were larger than the penumbra area, and the penumbra zone were positively correlated with viable zone.Conclusion 1, DWI and ASL scan technique can be inferred initial acute phase after traumatic brain injury, there may be a "traumatic penumbra zone" around focal cerebral contusion. They can be restored by clinical treatment.2, DWI and ASL technology is a completely noninvasive, which provide useful information on traumatic brain edema and brain tissue perfusion decreased for neurosurgeons to know the diagnosis of the patient and the treatment providing useful information and best therapeutic time window.