Correlation of the ferrum and VEGF with magnetic resonance imaging in chronic subdural hematomas: a prospective study

In this study, we measured the level of ferrum ion and VEGF from the hematoma cavity fluid in chronic subdural hematoma (CSDH), and analyzed the relationship between these values with the CSDH diagnosis by MRI. The cranial MRI appearance of each CSDH were classified as hypodense, isodense, hyperdense, or mixed density. The concentrations of ferrum ions in serum and hematoma cavity fluid were measured before and after operation, and the VEGF level in hematoma cavity was examined by ELISA. Totally, the ferrum ion concentration in hematoma cavity fluid was higher than that in periphery serum. In hypodense hematomas (n=5), ferrum and VEGF was 55.24±12.57 μmol/L, 7254.40±575.88 pg/ml, respectively. In isodense hematomas (n=6), ferrum and VEGF was 65.18±8.63 μmol/L, 8194.17±619.47 pg/ml, respectively. In hyperdense hematomas (n=7), ferrum and VEGF was 38.96±6.37 μmol/L and 6142.43±549.87 pg/ml, respectively. In mixed-density hemotomas (n=7), ferrum and VEGF was 45.99±10.11 μmol/L, 6861.00±686.89 pg/ml, respectively. There was significant difference of ferrum and VEGF between 4 classes of MRI appearance (P<0.05). Meanwhile, earlier age and shorter onset days were found in hyperdense hematomas with lower ferrum and VEGF. The ferrum concentration and VEGF level was correlated with the MRI signal density in CSDH.