CT灌注成像在高血压性脑出血亚急性期的应用研究  

Application Research of CT Perfusion Imaging in Hypertensive Cerebral Hemorrhage at Subacute Phase

作　　者：魏忠荣[1,2] 韩丹[3] 陆建环[1,2] 魏青[1,2] 

机构地区：[1]云南省玉溪市人民医院 [2]昆明医科大学第六附属医院CT室,653100 [3]昆明医科大学第一附属医院影像中心CT室,650032

出　　处：《临床放射学杂志》2015年第6期876-879,共4页Journal of Clinical Radiology

摘　　要：目的应用CT灌注成像（CTPI）研究高血压性脑出血（HICH）亚急性期血肿周围组织的血流灌注改变及其与血肿量的相关性。方法对入选的38例HICH行保守治疗于亚急性期采用80 k V、200 m A行CTPI,分别测量血肿区及边缘区、外层区及健侧镜像区的局部脑血容量（rCBF）、局部脑血流量（rCBV）、平均通过时间（MTT）值。根据出血量分两组：少量组14例（出血量约0-29 ml）,中等量组24例（出血量约30-69 ml）。对上述指标进行测量或评价,并行对比分析。结果 38例HICH血肿体积最大为67 ml,最小为5 ml,平均（23.93±15.69）ml;血肿边缘区rCBF、rCBV均较健侧镜像区明显减低、MTT明显延长,差异具有统计学意义（P〈0.05）。血肿区、边缘区及外层区rCBF、rCBV及MTT图呈＂阶梯＂样分布,血肿区灌注缺损最严重（P〈0.05）。边缘区rCBF与血肿量为低度相关,r值仅为-0.01。结论 HICH亚急性期血肿周围组织存在低灌注损伤;其低灌注程度与血肿体积无明显相关性;采用80 k V低剂量CTPI能明显降低辐射剂量。Objective To explore the changes of blood perfusion in the brain tissue around the hematoma at subacute phase of hypertensive intracerebral hemorrhage（ HICH） with CT perfusion image（ CTPI）,and its correlation with the hematoma volume. Methods In The cases of 38 patients undergone CTPI with 80 k V,200 m A at subacute phase after conservative treatment. measured the regional cerebral blood flow（ r CBF）,regional cerebral blood volume（ r CBV）,mean transit time（ MTT） of the hematoma,marginal,outer and healthy side mirror areas. The 38 cases were divided into two groups according to the hematoma volume： the small hematoma volume was about 0 ~ 29 ml（ 14 cases） and the medium hematoma volume about 30 to 69 ml（ 24 cases）. The above index were measured,assessed and compared. Results In the 38 cases,the maximum and minimum hematoma were 67 ml and 5 ml,and the mean number was 23. 93 ± 15. 69 ml.r CBF and r CBV of the tissue around hematoma were significantly lower than that of the health side mirror area and MTT was significantly prolonged（ P〈0. 05）,which was significantly statistical difference. r CBF,r CBV and MTT of the all areas appeared to a ladder diagram sample distribution from hematoma area to outer area： the perfusion defect of hematoma area was the most seriously（ all P〈0. 05）. The r CBF of the marginal area and hematoma volume were slightly correlated,with the respective related coefficient of- 0. 01. Conclusion There is a hypoperfusion area around the hematoma tissue at subacute phase of HICH,and there is no significantly correlation between the degree of hypoperfusion injury around the hematoma and the hematoma volume; the radiation dose can be obviously reduced by the using of 80 k V low dose CTPI technique.

关 键 词：脑出血 CT灌注成像 血流动力学 

分 类 号：R743.34[医药卫生—神经病学与精神病学]