脑CT灌注成像对轻型颅脑损伤预后的评估价值  

Evaluation value of CT cerebral perfusion imaging in prognosis of mild traumatic brain injury

作　　者：谢安明 尚峰 邓磊 王柳仙 魏文峰 范华刚 XIE Anming;SHANG Feng;DENG Lei;WANG Liuxian;WEI Wenfeng;FAN Huagang(Department of Radiology,the 908th Hospital of PLA Joint Logistics Support Force,Nanchang 330002,China;Department of Health care center,the 908th Hospital of PLA Joint Logistics Support Force,Nanchang 330002,China;Department of Neurosurgery,the 908th Hospital of PLA Joint Logistics Support Force,Nanchang 330002,China)

机构地区：[1]联勤保障部队第908医院放射诊断科,南昌330002 [2]联勤保障部队第908医院医疗保障中心,南昌330002 [3]联勤保障部队第908医院神经外科,南昌330002

出　　处：《武警医学》2023年第11期960-962,967,共4页Medical Journal of the Chinese People's Armed Police Force

基　　金：江西省卫健委科技计划课题(202131122)

摘　　要：目的探讨脑CT灌注成像技术对轻型颅脑损伤(mTBI)患者预后的评估价值。方法收集2020-01至2022-01联勤保障部队第908医院轻型颅脑损伤患者34例,行头颅64排CT平扫及脑CT灌注成像检查,脑创伤后1个月对患者进行随访及Rivermead脑震荡症状问卷评分(RPQ)作为预后评估指标。结果30例(88.2%)发现脑灌注异常,12例(35.3%)出现脑震荡后综合征(PCS)阳性(RPQ>14分),4例(11.8%)未见异常灌注改变。30例灌注异常患者中PCS阳性11例(36.7%),4例无灌注异常患者PCS阳性中仅1例(25.0%)。灌注异常区域主要表现为额叶或颞叶局灶性低灌注改变。结论脑CT灌注成像有助于了解mTBI患者血流动力学变化情况,对评价病情严重程度,及时纠正脑微循环异常具有重要意义。Objective To evaluate the value of CT cerebral perfusion imaging in the prognosis of patients with mild traumatic brain injury(mTBI).Methods A total of 34 patients with mTBI collected in the 908th Hospital of PLA Joint Logistics Support Force who underwent CT plain scan and perfusion imaging examination were reviewed one month after TBI using Rivermead post-concussion symptoms questionnaire(RPQ)scores as prognostic indicators.Results Abnormal cerebral perfusion was found in 30 cases(88.2%).Post-concussion syndrome(PCS)was positive in 12 cases(35.3%)(RPQ score>14).No abnormal perfusion changes were observed in 4 patients(11.8%).Of the 30 patients with abnormal perfusion,11cases(36.7%)showed PCS,while only 1(25%)of the 4 patients without abnormal perfusion were PCS positive.The areas with abnormal perfusion were mainly manifested as focal hypoperfusion in the frontal and temporal lobes.Conclusions The hemodynamic changes in patients with mTBI canbe assessed by CT cerebral perfusion imaging,which may further help to guide the evaluation of disease severity and timely treatment of the abnormal cerebral microcirculation,thus improving the prognosis of mTBI.

关 键 词：CT灌注成像 轻型颅脑损伤 脑震荡后综合征 

分 类 号：R743[医药卫生—神经病学与精神病学]