脑出血患者CT灌注成像的影像学特点  

Imaging Features of CT Perfusion in Intracerebral Hemorrhage Patients

作　　者：孙祥荣[1] 郭富强[1] 陶克言[1] 王多姿[1] 

机构地区：[1]四川省人民医院神经内科,成都610072

出　　处：《临床放射学杂志》2010年第3期299-302,共4页Journal of Clinical Radiology

摘　　要：目的探讨脑出血(ICH)患者CT灌注成像(CTP)的影像学特点。资料与方法27例患者于发病后5h～2周行CTP检查,观察其影像学特点。结果上矢状窦的时间密度曲线稳定,能够反映ICH后颅内的总体灌注情况。灌注缺损面积介于血肿与水肿加血肿面积之间;这种现象在基底节区前后侧比左右侧明显,且在某一方向更为显著;血肿周围灌注降低呈阶梯样改变,靠近血肿区达到缺血损伤的程度。ICH并发脑积水患者的灌注明显降低。脑血管畸形继发的出血可见血管影像。结论CTP可以反映ICH患者颅内的血液动力学变化,血肿周围存在缺血性损伤,这种损伤可能与血肿压迫和出血时的机械损伤等有关。CTP能够反映脑积水和颅内高压继发的低灌注。亦可能在鉴别出血的原因和出血方式上有一定的提示作用。Objective To investigate the computered tomography perfusion （CTP） features in intracerebral hemorrhage（ICH） patients.Materials and Methods 27 patients with supratentorial ICH undergone CTP at different time after onset of ICH （from 5h to 2 weeks） and the imaging features of CTP were observed.Results The time density curves（TDC） of superior sagittal sinus were stable,which could reflect the overall intracranial perfusion of ICH patients.The size of perfusion deficit area was between that of edema and that of hematoma and edema.The deficits were more evident on the AP orientation than that on the left-right orientation,especially on a certain direction in the basal ganglia area.All the parameter maps were concentrically distributed and gradually improved from the core to the periphery.The perfusion deficit band were existed surround the haematoma.The perfusion was obviously reduced in the area of hemorrhage complicated with hydrocephalus.The cerebrovascular malformation could be displayed on MIP or on parameter maps.Conclusion The haemodynamic changes in ICH patients can been detected by CTP.Ischemic lesions exist arrioud the hematoma,which is caused by the compression of the heamatoma and other factors.The reduced perfusion secondary to hydrocephalus can be detected.CTP can give a clue to make diagnosis of the cause and the style of the ICH.

关 键 词：脑出血 CT灌注成像 脑缺血损伤 脑积水 脑血管畸形 

分 类 号：R743.34[医药卫生—神经病学与精神病学] R816.1[医药卫生—临床医学]