创伤性颅脑损伤CT灌注成像的临床应用  

Clinical application of CT perfusion imaging in traumatic brain injury

作　　者：刘科[1,2] 方波[1,2] 胡晞[1,2] 程凯敏[1,2] 邹胜伟[1,2] 

机构地区：[1]重庆重庆市急救医疗中心神经外科 [2]重庆市急救医学研究所,400014

出　　处：《创伤外科杂志》2010年第6期500-503,共4页Journal of Traumatic Surgery

基　　金：重庆市卫生局医学科研项目(2009-2-090)

摘　　要：目的探讨CT灌注成像(CTP)在创伤性颅脑损伤中应用的可能性,评估其对预后的判断价值。方法回顾性分析17例创伤性颅脑损伤病人CT灌注参数及图像,并与头颅CT平扫进行比较。结果 17例中CT平扫见创伤组织及周围脑实质低密度灶13例;CT灌注参数显示脑组织低灌注11例(64.7%),术区及挫伤脑组织高灌注4例(23.5%),2例未见明显脑组织灌注异常。低灌注者预后不良。结论对创伤性颅脑损伤行CT灌注有助于了解颅脑损伤后局部脑组织血流灌注情况,对预后判断提供帮助;在创伤性颅脑损伤的治疗中不仅注意脑低灌注,还应注意高灌注的存在。Objective To investigate the effect of CT perfusion（CTP） imaging in traumatic brain injury（TBI） and evaluate its value for patient＇s outcome.Methods CTP was performed in 17 TBI patients during 1 week after admission,and CTP pictures and CT perfusion parameters including rCBF,rCBV and MTT were obtained.Results Totally 13 cases had a low density around the brain-damaged area on the CT scan.Lower rCBF,rCBV and delayed MTT were observed in 11 cases,and high rCBF,rCBV were in 4 cases.Cerebral hypoperfusion in TBI indicated a poor outcome.Conclusion CTP is an advanced technique to investigate the regional cerebral tissue perfusion in TBI patients.Clinicans should be aware of hypoperfusion or hyperperfusion around traumatic areas in the treatment of TBI.

关 键 词：颅脑损伤 CT成像 血流动力学 预后 

分 类 号：R651.1[医药卫生—外科学] R814.4[医药卫生—临床医学]