一站式全脑动态容积CTP-CTA成像对颅脑损伤后脑血管痉挛的诊断价值  

Diagnosis value of one stop whole brain dynamic volume CTP-CTA imaging in cerebral vasospasm after traumatic brain injury

作　　者：余惠平[1] 张和平[1] 李进淼[1] 

机构地区：[1]福建医科大学附属泉州第一医院神经外科,362000

出　　处：《神经疾病与精神卫生》2017年第3期194-197,F0003,共5页Journal of Neuroscience and Mental Health

摘　　要：目的 探讨一站式全脑动态容积CT灌注成像（CTP）联合CT血管成像（CTA）成像在颅脑损伤后脑血管痉挛中的应用及临床意义.方法 50例可疑有症状性脑血管痉挛表现的患者接受一站式全脑动态容积成像,CTP检查结果与对侧镜像区进行比较.结果 50例颅脑损伤患者中48例患者CTP存在原脑损伤范围外的低灌注区,同临床症状相符,准确性达96%,同对侧镜像区进行比较,各参数脑血流量（CBF）、脑血容量（CBV）、平均通过时间（MTT）及达峰时间（TTP）差异皆有统计学意义;50例颅脑损伤患者其中42例患者3D-CTA存在颅内大血管痉挛.结论 一站式全脑动态容积CTP-CTA成像技术应用于颅脑损伤后脑血管痉挛,通过CTP显示脑实质低灌注区以判断脑实质微循环血管痉挛的存在,CTA判断脑实质外大血管痉挛的存在,即CTP联合CTA对颅脑损伤后脑血管痉挛的早期诊断、治疗方案的选择、疗效的评估均有重要临床价值.Objective To explore the application and clinical significance of one stop whole brain dynamic volume CTP-CTA imaging in cerebral vasospasm after traumatic brain injury. Methods Totals of 50 patients with suspected symptomatic cerebral vasospasm were treated with one stop whole brain dynam- ic volume imaging. The results of CTP were compared with that of the contralateral mirror area. Results In 50 patients, 48 showed low perfusion areas outside the scope of brain injury which was consistent with clinical symptoms. The accuracy rate was 96%. There were significant differences in cerebral blood flow （CBF）, cerebral blood volume （CBV）, time-to-peak （TTP） and mean transit time （MTT） compared to the contralateral mirror area. In 50 traumatic brain injury patients, 42 showed intracranial vasospasm of great vessels in 3D-CTA. Conclusions One-stop whole brain dynamic volume CTP-CTA imaging could be applied in evaluating cerebral vasospasm after traumatic brain injury. Microcirculation vasospasm in brain parenchyma could be detected by low perfusion cerebral area in CTP. Vasospasm of great vessels outside brain parenchyma could be detected by CTA. Therefore, CTP combined with CTA has significant clinical value in early diagnosis, selection of treatment options and evaluation of efficacy for cerebral vasospasm after traumatic brain injury.

关 键 词：颅脑损伤 脑血管痉挛 灌注 血管成像 

分 类 号：R743.35[医药卫生—神经病学与精神病学]