Computed tomography-derived Ktrans and serum S100B in quantitative evaluation of blood-brain barrier permeability in traumatic brain injury.

PURPOSE: Traumatic brain injury (TBI) often leads to blood-brain barrier (BBB) disruption, contributing to secondary brain damage. Perfusion computed tomography (PCT) may assess BBB permeability through the transfer constant (Ktrans), while serum S100 calcium-binding protein B (S100B) serves as a biomarker of BBB integrity. However, the relationship between PCT derived Ktrans and serum S100B concentrations in TBI has not been fully explored.

METHODS

This observational study included 26 adult patients with moderate or severe TBI. PCT was performed 12-24 h after admission to measure Ktrans values in the pericontusional edema region. Serum S100B levels were measured at regular intervals during the first 36 h. Correlations between Ktrans and S100B were analyzed using Spearman's rank correlation, and the predictive capacity of mean Ktrans for serum S100B rise was evaluated using receiver operating characteristic (ROC) analysis.

RESULTS

A significant positive correlation was found between both initial and peak serum S100B concentrations and mean Ktrans (rs = 0.52, p = 0.018 and rs = 0.47, p = 0.029, respectively) and maximum Ktrans values (rs = 0.47, p = 0.029 and rs = 0.56, p = 0.011, respectively). ROC analysis showed that mean Ktrans values predicted serum S100B rise with AUC of 0,74 (CI 95%: 0.55, 0.91).

CONCLUSIONS

Our findings demonstrated a significant correlation between pericontusional Ktrans values and serum S100B concentrations, with mean Ktrans values showing potential as an early predictor for serum S100B rise. These findings suggest that combining PCT and serum biomarkers could improve assessment of BBB integrity and aid in the management of TBI.