Comparison of Cerebral Oxygen Saturation and Cerebral Perfusion Computed Tomography in Cerebral Blood Flow in Patients with Brain Injury

Abstract

The purpose of this study was to determine the relationship between cerebral tissue oxygen saturation and cerebral blood volume in patients with traumatic brain injury. Perfusion computed tomography of the brain was performed in 25 patients with traumatic brain injury together with simultaneous SctO2 level measurement using cerebral near-infrared oxymetry. The mean age of the injured persons was 34.5±15.6 years (range 15-65); 14 men, 11 women. The Injury Severity Score (ISS) values were 44.4±9.7 (range 25-81). The Glasgow Coma Score (GCS) mean value before the study was 10.6±2.1 (range 5-13). SctO2 ranged from 51 to 89%, mean 62±8.2%. Cerebral blood volume (CBV) values were 2.1±0.67 ml/100 g (min 1.1; max 4.3 ml/100 g). Cerebral blood flow (CBF) was 31.99±13.6 ml/100 g×min. Mean transit time (MTT) values were 5.7±4.5 s (min 2.8; max 34.3 s). The time to peak (TTP) was 22.2±3.1 s. A statistically significant correlation was found between SctO2 level and cerebral blood volume (CBV) level (R=0.9; p<0.000001). No other significant correlations were found between brain tissue oxygenation and other parameters of brain perfusion.

Abnormalities on Perfusion CT and Intervention for Intracranial Hypertension in Severe Traumatic Brain Injury

“…Despite over a decade of research on CTP in the STBI population, there is still a paucity of studies with relatively small sample sizes. Several studies have investigated the potential uses for CTP in quantifying cerebral perfusion abnormalities in STBI [ 10 , 11 , 12 , 13 ], as well as changes after treatment [ 14 , 15 , 16 , 17 ] and prognostication [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ]. This information may be helpful to guide the selection of patients for invasive ICP monitoring.…”

“…In studies in STBI patients, ICH has been associated with lower cerebral blood flow on CTP [ 9 ]. Abnormalities on CTP have also been shown to correlate with abnormalities in CPP and loss of cerebral autoregulation [ 10 , 11 , 12 , 13 ]. Several small studies have used CTP to investigate the cerebral blood flow changes after intervention for ICH in humans [ 14 , 15 , 16 ], and in animal models [ 17 ], CTP has been shown to predict short- and long-term functional outcomes in both mild and severe traumatic brain injury [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ].…”

Perfusion Computed Tomography in Traumatic Brain Injury

“…A proportional dependence was observed between cerebral tissue oxygenation and CBV, but not with CBF and MTT. Possibly, vasospasm and cerebral autoregulation were responsible for the lack of maintained relationship between cerebral oxygenation and CBF (which should otherwise be observed considering that CBF=CBV/MTT) [29].…”

“…The relationship between cerebral oxygen saturation and brain perfusion maps has been investigated in a heterogeneous cohort of patients with a degree of TBI ranging from severe to moderate [29]. The authors obtained perfusion maps using single slice technology and compared with frontal cerebral oximetry in 25 patients (16 with cerebral ischemia on perfusion CT maps).…”

“…A literature research including the terms "traumatic brain injury" and "perfusion CT" or "perfusion computed tomography" returned 185 results. Critical screening of the abstracts selected 18 papers that were considered as pertinent and relevant to this review and therefore they were analyzed and discussed in detail [16,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]. Table 1 illustrates the studies' characteristics and main findings.…”