应用CT灌注成像研究兔蛛网膜下腔出血后脑血流的变化  

Changes of cerebral blood flow with perfusion CT after experimental subarachnoid hemorrhage in rabbits

作　　者：于涛[1] 王中[1] 周岱[1] 姚选军[2] 胡春洪[2] 

机构地区：[1]苏州大学附属第一医院神经外科,215006 [2]苏州大学附属第一医院影像中心,215006

出　　处：《江苏医药》2005年第9期683-685,共3页Jiangsu Medical Journal

摘　　要：目的应用CT灌注成像技术(PCT)研究兔蛛网膜下腔出血(SAH)后脑血流的变化并探讨其临床应用价值。方法动物分正常组、假手术组、SAH1d组、3d组、7d组、14d组共6组。经颞开颅二次注血法制作兔SAH模型。首次注血后1d、3d、7d、14d进行PCT检查,观察局部脑血流量(rCBF)、局部脑血容量(rCBV)、达峰时间(TTP)的变化。HE常规染色病理检查。结果正常组的rCBF、rCBV和TTP分别为(142·283±9·749)ml·min-1·100g-1、(247·517±37·920)ml·min-1·100g-1和(3·383±0·194)s。SAH组,rCBF SAH后第1天即开始下降,以第3天最为明显[(62·583±5·123)ml·min-1·100g-1],随后开始恢复,但是在第14天时仍没有达到正常;rCBV在SAH后第1天下降,第7天时升高,第14天时恢复正常;TTP在SAH后第1天开始延长,第3天最为明显(P<0·01),第7天有所恢复,第14天时仍为正常的1·9倍(P<0·01)。病理检查显示局部脑区有神经元的细胞质浓缩、核浓染等改变,以SAH后第7天最为明显。结论CT灌注成像可以方便、有效地检测SAH后的脑血流动力学变化,并可根据各种参数的比值及相关关系提供相关的脑血流动力学信息,提示有无脑缺血以及脑缺血的程度。Objective To investigate the value of perfusion CT（PCT） on the experimental subarachnoid hemorrhage（SAH） in rabbit. Methods The rabbits received two subarachnoid injections of autologous arterial blood（ 1 ml/kg）to induce SAH, PCT was used on the 1st, 3rd, 7th and 14th day. Regional cerebral blood flow（rCBF）, regional cerebral blood volume（rCBV）, time to peak（TTP） were measured based on the S-T curve. HE staining was performed for pathology. Results rCBF, rCBV and TTP in normal rabbits were（142. 283±9. 749） ml · min^-1 · 100g^-1 ,（247. 517±37. 920） ml · min^-1 · 100g^-1 and （3. 383±0. 194）s respectively, rCBF clearly decreased as early as on the 3rd day after SAH E（62. 583±5. 123） ml · min^-1 , 100g^-1],increased on the 7th day, but was still abnormal on the 14th day. rCBV decreased markedly on the 3rd day and increased on the 7th day, then came back. TTP was prolonged on the 3rd day. Denaturalization was observed pathologically in regional brain, and more obviously on the 7th day after SAH. Conclusion PCT is a convenient and effective technique for evaluating hemodynamics after SAH. Analyzing the relationship of rCBF,rCBV,and TTP is helpful to know the status of the capillary vessels in the brain and can provide functional information. It also provides the clues indicating the exist of ischemia and the grade.

关 键 词：蛛网膜下腔出血 CT灌注成像 血流动力学 蛛网膜下腔出血(SAH) CT灌注成像技术 局部脑血流量 成像研究 血流动力学变化 兔 临床应用价值 

分 类 号：R743.35[医药卫生—神经病学与精神病学] R814.42[医药卫生—临床医学]