多层螺旋CT灌注成像评价蛛网膜下腔出血后区域脑灌注不足的实验研究  

Evaluation of regional cerebral perfusion after subarachnoid hemorrhage by multi spiral CT perfusion

作　　者：王宏清[1] 杨运俊[1] 陈伟建[1] 梁盼[1] 吴楠[1] 林伯法[1] 

机构地区：[1]温州医学院附属第一医院放射影像中心,浙江省温州325000

出　　处：《中国基层医药》2012年第2期179-181,共3页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省教育厅基金资助项目（Y200803182）

摘　　要：目的探讨蛛网膜下腔出血（SAH）后多层螺旋cT灌注成像（MS-CTP）评价区域脑灌注减低的应用价值。方法将32只清洁级雄性日本大耳白兔随机分成两组，其中A组（正常组）8只，B组（SAH组）24只。采用枕大池二次注血法构建兔SAH模型．在造模后第7天行MS-CTP扫描。原始数据通过灌注分析软件获得两侧额顶及基底节的平均脯血流量（CBF）灌注参数图。并于MS-CTP扫描结束后立即处死、取脑，观察SAH情况。结果两组实验动物额部（t=1．740，P=0．092）、顶部（t=1．868．P=0．072）平均CBF值差异元统计学意义，基底节区差异有统计学意义（t=2．481，P=0．019）。B组实验动物兔基底池可见血凝块分布，而额、顶部未见血凝块存在。结论MS-CTP能够监测SAH后兔脑微循环灌注的变化．并得出区域脑灌注减低与血凝块的分布有关，从而指导SAH后脑灌注减低的早期诊断，有利于临床进行早期的干预治疗。Objective To explore the chiaical value of cerebral perfusion reduction after subarachnoid hemorrhage（SAH） by multi spiral CT perfusion in rabbits. Methods 32 male Japanese big-ear rabbits of clean level were randonfly divided into 2 groups ： Group A （ n = 8）, the normal group, were to obtain normal MS-CTP values of rabbit cerebrums;Group B（ n = 24） ,the SAIl group was made into two-hemorrhage animal models,checked on seven day by multi spiral CT perfusion. The source data was transmitted to tile post-processing workstation ADW 4.2. Perfusion parameters maps（CBF） of both sides of frontal,parietal and basal ganglia were got by computing. Each rabbit was killed immediately after scanning, and tile spider blood was observed. Results The average CBF value of the two groups ： The difference was not statistically significant at tile frontal （ t = 1. 740, P = 0. 092） and parietal （ t= 1. 868, P = 0. 072） ; The average values of CBF were significantly decreased at the basal ganglia （ t = 2. 481, P = 0. 019 ）. Group B showed the distribution of blood clot in the basal cistern, but there was no blood clot at the frontal and parietal. Conclusion The monitor perfusion changes of rabbit brain after SAH could be detected by MS-CTP,and the lower of regional cerebral perfusion had a relationship with the distribution with the blood clot, and it could instruct the early diagnosis of cerebral perfusion,and the clinical benefit to early intervention treatment.

关 键 词：蛛网膜下腔出血 体层摄影术 X线计算机 灌注 脑 

分 类 号：R816.1[医药卫生—放射医学] R743.3[医药卫生—临床医学]