256层螺旋CT灌注成像对高压电击伤截肢适应证判断的初步应用  

256-slice spiral CT perfusion imaging as prognostic indicator of healing after limb amputation for high-voltage electrical burn

作　　者：徐勇辉[1] 孙勇[1] 刘灿丽[1] 柳瑞[1] 濮进敏[1] 杨新民[1] 

机构地区：[1]昆明医科大学第二附属医院放射科,云南昆明650031

出　　处：《影像诊断与介入放射学》2015年第1期59-63,共5页Diagnostic Imaging & Interventional Radiology

摘　　要：目的探索256层螺旋CT灌注成像技术对于四肢高压电击伤后损伤肢体截肢及保肢中的初步应用价值。方法收集我院高压电击伤截肢患者61例,其中截肢19例,在术前行灌注检查,术后确定截肢平面并采集截肢平面与截肢平面下灌注数据,将检查结果(肌肉微循环灌注信息及相应部位血管CTA图像)与手术结果以及患侧肢体不同平面灌注参数对照。将灌注所得图像传入Phillips公司专属EBW工作站,用Functional CT-general模式行灌注图像处理(去卷积算法)。结果 (1)高压电损伤后肌肉、皮肤、骨骼CT影像表现:患者肌肉损伤在CT平扫、增强图像上一般表现为低密度影;皮肤损伤表现为皮肤局部缺损、皱褶;血管表现为中断;(2)高压电损伤后不同患者CT灌注表现:高灌注、低灌注及无血流灌注表现均可。结论应用256层螺旋CT灌注诊断四肢高电压损伤,能够获得清晰的血管CTA图像及不同损伤部位灌注参数值,并且这些灌注参数对皮瓣修复的预后具有评判价值;MSCT灌注成像对高压电损伤截肢与否具有一定的帮助作用。Objective To explore the efficacy of 256-slice spiral CT perfusion imaging as prognostic indicator of healing after limb amputation for high-voltage electrical injury. Methods 61 patients with high-voltage electrical burn including 19 patients with above-knee amputation underwent CT perfusion imaging..The muscle microcirculation perfusion parameters were compared to the surgical findings. Results The injured muscles showed decreased density and contrast enhancement with skin wrinkles or defects, and vascular disruption. The CT perfusion was high, low or absent. Conclusion 256-slice spiral CT perfusion imaging depicts the blood vessels clearly and the perfusion parameters can be used as prognostic indicators of skin flap healing afterlimb amputation for high-voltage electrical injury.

关 键 词：体层摄影术 X 线计算机 灌注成像 高压电损伤 

分 类 号：R647[医药卫生—外科学] R816.8[医药卫生—临床医学]