慢性高原病脑部MSCT表现与血流动力学研究  

Multi-slice Spiral Computed Tomography Manifestations of Brain and Cerebral Hemodynamics in Chronic Mountain Sickness

作　　者：王铎尧[1] 鲍海华[1] 赵希鹏[1] 李文方[1] 

机构地区：[1]青海大学附属医院影像中心,青海西宁810001

出　　处：《实用放射学杂志》2011年第3期322-326,共5页Journal of Practical Radiology

摘　　要：目的 观察慢性高原病（chronic mountain sickness,CMS）患者脑部多层螺旋CT（MSCT）改变.方法 研究对象共27例,其中12例为临床确诊的CMS,其余15例为正常健康志愿者.采用Philips Brilliance 16层螺旋CT对27例研究对象行脑部CT平扫加灌注扫描.结果 （1） CMS患者8例CT平扫表现为脑肿胀,脑沟裂变浅,脑室系统变小.12例患者颅内血管密度均有不同程度的增高,尤其以上矢状窦和大脑中动脉为著.通过测量分析上矢状窦CT值和双侧大脑中动脉CT值与血红蛋白（Hb）含量分析,CMS组上矢状窦CT值和双侧大脑中动脉CT值高于正常组 （ t=4.551,P〈0.01和t=2.898,P〈0.01 ）.CMS组Hb含量与上矢状窦及大脑中动脉血管密度CT值均呈正相关（r=0.758,P〈0.01 及r=0.740,P〈0.01）.（2） CMS患者脑灰质脑血流量（CBF）值较正常对照组减小,P〈0.01,并且TTP和MTT明显延长,P〈0.05和P〈0.01 脑白质MTT值明显延长,P〈0.01.结论 MSCT对研究CMS脑部形态学和血液动力学方面均具有重要意义.Objective To observe MSCT appearances of brain in chronic mountain sickness（CMS）. Methods 27 subjects were collected involved in this study,including 12 patients with CMS and 15 normal adults as control. Plain CT scan and perfusion CT imaging were performed in all subjects. Cerebral blood flow （CBF）, cerebral blood volume （CBV）, time to peak enhancement （TTP） and mean transit time （MTT） were measured within the specific regions of interest （ROI） of the brain,and quantitative analysis was performed. Results （1） There were 8 cases in CMS group with diffuse cerebral edema, small scbizencephaly and shrinking ventricular system. The density of blood vessel in the brain was differently enhancement （12 cases）. There was an obvious correlation between the density of cerebral vessels （bilateral middle cerebral artery and superior sagittal sinus） and the hemoglobin level. The CT values of bilateral middle cerebral artery and superior sagittal sinus were significantly higher in CMS group than that in normal group （t=4. 551, P〈0.01 and t= 2. 898,P〈0.01, respectively） . In CMS group , the CT value of superior sagittal sinus and bilateral middle cerebral artery with hemoglobin level （r=0. 758 and r=0. 740 , both P〈0.01）. {2） The changes of CBF were obviously in grey matter than in white matter. In grey matter,CBF reduced more in CMS group than in normal group（P〈0.01）. TTP in grey matter prolonged obviously in CMS group （P〈0. 05 ）. MTT in grey matter and white matter both prolonged obviously in CMS group （P〈0.01）. Conclusion Multi-slice spiral CT is a valuable tool to study the state of the whole brain and the cerebral hemodynamics in CMS patients.

关 键 词：脑 慢性高原病 体层摄影术 X线计算机 

分 类 号：R742[医药卫生—神经病学与精神病学] R814.42[医药卫生—临床医学]