螺旋CT重建技术及脑灌注成像在急性颅脑外伤动态变化中的应用价值  

The value of spiral CT reconstruction techniques and brain perfusion imaging in dynamic change of acute traumatic brain injury

作　　者：张雪峰 穆耀强 高洁 郭靖 李俊林 郭亚茹 

机构地区：[1]内蒙古自治区人民医院磁共振室,呼和浩特010017 [2]内蒙古包头第四医院影像科,包头014030

出　　处：《中国实用神经疾病杂志》2013年第19期15-16,共2页Chinese Journal of Practical Nervous Diseases

摘　　要：目的 探讨螺旋CT重建技术及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 选取我院80例急性颅脑外伤患者作为研究对象,所有患者均于伤后3～6 h内行多层螺旋CT平扫及脑灌注成像检查,并于伤后2～7 d动态复查颅脑CT.结果 （1）MSCT共检查8例脑挫裂伤,6例硬膜下血肿,8例硬膜外血肿,10例蛛网膜下腔出血,4例脑内血肿;超薄MSCT检出数分别为18、10、13、21、12例;CTP检出数分别为31、26、24、29、23例.CTP检查率最高,超薄MSCT次之,MSCT最低.（2）常规MSCT与超薄MSCT两种检查方法比较,超薄MSCT在脑挫裂伤、脑内血肿的检出率显著高于MSCT检查,差异有统计学意义（P＜0.05）.常规MSCT与CTP检查结果比较发现,CTP对各项脑损伤检查结果阳性率均显著高于常规MSCT检查结果,差异有统计学意义（P＜0.05）.对超薄MSCT及CTP两种检查结果检出率比较发现,TCTP对脑挫裂伤、硬膜下血肿、硬膜外血肿、脑内血肿检出率显著高于超薄MSCT,差异有统计学意义（P＜0.05）.结论 螺旋CT重建技术及脑灌注成像可提高诊断急性颅脑损伤的准确率,减少误诊,为早期干预和治疗提供理论依据.Objective To explore the clinical value of spiral CT reconstruction techniques and brain perfusion imaging in dynamic changes of acute traumatic brain injury. Methods Totally 80 patients with acute traumatic brain injury were included in the study. All patients underwent multilayer spiral CT scan cerebral perfusion imaging at 3 to 6h after injury. And at 2 to 7d after the injury brain CT dynamic review were performed. The data were analyzed to explore the clinical value of spiral CT reconstruction techniques and brain perfusion imaging in dynamic changes of acute traumatic brain injury. Results MSCT checked out 8 cases of cerebral contusion, 6 cases of subdural hematoma, 6 cases epidural hematoma, 10 cases subarachnoid hemorrhage, 4 cases intracerebral hematoma ; ultra-thin MSCT detected 18,10,13,21,12 cases, respectively ; the CTP detected 31, 26,24,29,23 cases, respectively. CTP had the highest detecting rate, followed by thin MSCT, the MSCT minimum. Detection rate of ultra--thin MSCT in cerebral contusion and intracerebral hematoma were significantly higher than MSCT （P〈0.05）; Positive rate of CTP on various brain injury was significantly higher than that of MSCT （P,0.05） ; the detection rate of cerebral contusion, subdural hematoma, epidural hematoma, intracerebral hematoma by CTP were significantly higher than the ultra-thin MSCT （P〈0.05）. Conclusion Spiral CT reconstruction techniques and brain perfusion imaging can improve the accuracy of diagnosis of acute traumatic brain injury patients, reduce the incidence of misdiagnosis and provide a theoretical basis for early intervention and treatment.

关 键 词：脑外伤 螺旋CT重建技术 脑灌注成像 

分 类 号：R651.15[医药卫生—外科学]