CT灌注成像在高血压性脑出血亚急性期的应用研究

发布时间：2018-06-15 02:07

本文选题：脑出血 + CT灌注成像　；参考：《临床放射学杂志》2015年06期

【摘要】：目的应用CT灌注成像(CTPI)研究高血压性脑出血(HICH)亚急性期血肿周围组织的血流灌注改变及其与血肿量的相关性。方法对入选的38例HICH行保守治疗于亚急性期采用80 k V、200 m A行CTPI,分别测量血肿区及边缘区、外层区及健侧镜像区的局部脑血容量(rCBF)、局部脑血流量(rCBV)、平均通过时间(MTT)值。根据出血量分两组:少量组14例(出血量约0~29 ml),中等量组24例(出血量约30~69 ml)。对上述指标进行测量或评价,并行对比分析。结果 38例HICH血肿体积最大为67 ml,最小为5 ml,平均(23.93±15.69)ml;血肿边缘区rCBF、rCBV均较健侧镜像区明显减低、MTT明显延长,差异具有统计学意义(P0.05)。血肿区、边缘区及外层区rCBF、rCBV及MTT图呈"阶梯"样分布,血肿区灌注缺损最严重(P0.05)。边缘区rCBF与血肿量为低度相关,r值仅为-0.01。结论 HICH亚急性期血肿周围组织存在低灌注损伤;其低灌注程度与血肿体积无明显相关性;采用80 k V低剂量CTPI能明显降低辐射剂量。
[Abstract]:Objective to study the changes of blood flow perfusion in subacute hematoma tissue of hypertensive intracerebral hemorrhage (HICH) and its correlation with hematoma volume by CT perfusion imaging (CTPI). Methods 38 patients with HICH were treated conservatively in subacute stage with 80 kV / 200 Ma CTPI. The regional cerebral blood volume (rCBFV), regional cerebral blood flow (RCBV) and mean transit time (MTT) were measured in the hematoma area and marginal area, the outer area and the mirror region of healthy side respectively. According to the amount of blood loss, 14 cases were divided into two groups: 14 cases in a small amount group (0 ~ 29 ml / L) and 24 cases in a medium dose group (30 ~ 69 ml / L). The above indexes are measured or evaluated, and parallel comparative analysis is carried out. Results the volume of hematoma in 38 cases of HICH was 67 ml, the smallest was 5 ml, the mean value was 23.93 卤15.69 ml, the rCBFV in the marginal region of hematoma was significantly lower than that in the contralateral mirror region, and the difference was statistically significant (P 0.05). The rCBFU rCBV and MTT in hematoma area, marginal area and outer layer were "ladder" like distribution, and the most serious perfusion defect was P0.05 in hematoma area. The rCBF in the marginal area was only -0.01, which was lower correlated with the hematoma volume. Conclusion there is low perfusion injury in the tissue around hematoma in the subacute phase of HICH, and there is no significant correlation between the degree of low perfusion and the volume of hematoma, and low dose CTPI of 80 kV can significantly reduce the radiation dose.
【作者单位】：云南省玉溪市人民医院;昆明医科大学第六附属医院CT室;昆明医科大学第一附属医院影像中心CT室;
【分类号】：R743.34;R816.1

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