多层螺旋CT三维图像重建和脑灌注成像在急性颅脑损伤动态变化中应用  

Multi-slice spiral CT three-dimensional imaging and perfusion imaging in acute brain injury of dynamic application

作　　者：杨小秦[1] 柳少光[1] 王治民[1] 王学斌[1] 张可[1] 魏晓东[1] 张冬志[1] 

机构地区：[1]甘肃省人民医院急诊中心,兰州730000

出　　处：《中华神经外科杂志》2012年第11期1163-1166,共4页Chinese Journal of Neurosurgery

基　　金：甘肃省科技厅“十一五”科技支撑计划项目（1011FKCA099）

摘　　要：目的探讨超薄多层螺旋CT、颅骨三维图像重建和脑灌注成像在急性颅脑外伤动态变化中的临床应用价值。方法收集2009年12月至2011年10月我院收治的245例急性颅脑外伤（TBI）检查资料，均于伤后3—6h行常规多层螺旋CT（MSCT），超薄多层螺旋CT以及颅骨三维图像重建和脑CT灌注成像（CTP）检查，全部病例于伤后2—7d动态复查MSCT和超薄MSCT，将数据进行回顾性分析，采用卡方检验评价。结果超薄MSCT在脑挫裂伤、脑内血肿诊断中优于常规MSCT；CTP除弥漫性轴索损伤无统计学意义外，其余明显优于常规MSCT；CTP在脑挫裂伤、硬膜下血肿和脑内血肿优于超薄MSCT差异具有统计学意义（P〈0．05）。颅骨三维图像重建在对颅骨骨折的检查优势明显。结论联合应用超薄MSCT、颅骨三维图像重建和CTP对于急性颅脑外伤早期和微小损伤的诊断优于常规MSCT，可以降低误诊率，并为早期治疗和预后判断提供可靠的依据。Objective Discussion of uhrathin muhilayer spiral CT 3D image reconstruction, skull and brain perfusion imaging in acute brain injury to dynamic changes in the clinical value. Methods 2009 December to 2011 October were collected in our hospital in 245 patients with acute traumatic brain injury patients check information, both in the 3 -6 h after injury within conventional muhislice spiral CT, thin multilayer spiral CT and three - dimensional image reconstruction of skull and brain CT perfusion imaging examination, all the cases in 2 to 7 days after injury dynamic review of conventional MSCT and ultrathin muhilayer spiral CT, the data were retrospectively analyzed, using the cbi -squared test evaluation. Results Super thin multilayer spiral CT in cerebral contusion and laceration, intracerebral hematoma in TBI with mixed diagnosis has statistics difference is better than the conventional MSCT. CTP in acute traumatic brain injury diagnosis was superior to conventional MSCT except diffuse axonal injury. CTP in cerebral contusion and laceration, subdural hematoma and intracerebral hematoma associated with intracerebral hematoma in the diagnosis with statistical difference, better than the uhrathin multilayer spiral CT （ P 〈 0. 05 ）. The 3D image reconstruction of skull fracture demonstrated great advantages in the treatment of skull fracture, which include cranial suture separation and basal skull fracture. Conclusion combined Super thin muhilayer spiral CT 3D image reconstruction skull and brain CT perfusion imaging for acute craniocerebral injury early diagnosis and minimal injury diagnosis is superior to conventional muhislice spiral CT, The rate of misdiagnosis can be decreased, which provide Reliable basis for early diagnosis and Prognosis of TBI.

关 键 词：颅脑外伤 多层螺旋CT 灌注 动态 成像 

分 类 号：R651.15[医药卫生—外科学]