CTP联合3D-ASL技术对高原红细胞增多症脑部血流动力学的探讨  

Study on hemodynamics of high altitude polycythemia by 3D-ASL combined with CT cerebral perfusion

作　　者：胡俊洁 孙艳秋[2] 王海洋 任艳丽 杨国仁[3] HU Junjie;SUN Yanqiu;WANG Haiyang;REN Yanli;YANG Guoren(Anyang Tumour Hospital,Anyang 455000 China;Qinghai Provincial People's Hospital,Xining 810000 China;Shandong Cancer Hospital,Jinan 250117 China)

机构地区：[1]安阳市肿瘤医院,河南安阳455000 [2]青海省人民医院,青海西宁810000 [3]山东省肿瘤医院,山东济南250117

出　　处：《中国辐射卫生》2021年第2期214-219,共6页Chinese Journal of Radiological Health

摘　　要：目的研究高原红细胞增多症(HAPC)CT脑灌注(CTP)的变化/核磁共振质子自旋标记技术(3D-ASL)的应用价值并进行对比研究。方法用多层螺旋CT(MDCT)研究22例不同程度高原红细胞增多症患者的CT脑灌注的变化;CT全脑灌注技术与核磁共振质子自旋标记技术(3D-ASL)在高原红细胞增多症脑部血流动力学改变中的应用价值的比较。结果HAPC随病情加重,大脑皮质和白质均脑血流量(CBF)呈下降趋势,除额叶白质和颞叶白质外,余部位不同病情间差异均有统计学意义(P<0.05);随病情加重,大脑各部位皮质和白质脑血容量(CBV)增加,白质更为显著,且各部位不同病情间CBV差异均有统计学意义(P<0.05);随病情加重,大脑各部位皮质和白质平均通过时间(MTT)均显著增加,各部位不同病情间MTT差异均有统计学意义(P<0.05);不同程度HAPC患者随病情加重(P<0.05),相对脑血流量(rCBF)降低,除顶叶皮质、颞叶白质和枕叶白质外,各部位不同病情间rCBF差异均有统计学意义;通过ROC曲线来评价CTP和ASL两者的诊断价值,两条曲线接近,CTP略优于ASL。结论不同程度HAPC患者随着病情进展,脑血流减低;血容量增加;血流平均通过时间延长;CTP与ASL两种方法效果接近,前者价值略优。Objective To investigate the changes of CT cerebral perfusion(CTP)and the application value of nuclear magnetic resonance proton spin labeling(3D-ASL)and to conduct a comparative study.Methods Multi-slice spiral CT(MDCT)was used to study the changes of CTP in 22 patients with HAPC.Comparison of CT whole-brain perfusion technique and nuclear magnetic resonance proton spin labeling technique(3D-ASL)in hemodynamic changes of the brain in plateau polycythemia.Results With the aggravation of HAPC,CBF of cerebral cortex and white matter showed a downward trend.Except the white matter of frontal lobe and temporal lobe,the difference of HAPC among different diseases was statistically significant(P<0.05).Along with the aggravation of,each part of the brain cortex and white matter CBV increase,white matter,and each part CBV difference had statistical significance between different condition(P<0.05).With the aggravation of the disease,the MTT of cortex and white matter in all parts of the brain increased significantly,and the difference of MTT between different parts of the disease was statistically significant(P<0.05).HAPC patients along with the aggravation of different level,rCBF is reduced,in addition to the parietal cortex,temporal and occipital white matter,white matter rCBF differences between different parts of different condition have statistical significance(P<0.05).ROC curve was used to evaluate the diagnostic value of CTP and ASL.The two curves were close to each other,and CTP was slightly better than ASL.Conclusion With the progression of HAPC,cerebral blood flow decreased,blood volume increased,and average blood flow time prolonged in patients with different degrees of HAPC.CTP and ASL had similar effects,and the former had slightly better value.

关 键 词：高原红细胞增多症 电子计算机断层扫描 灌注成像 磁共振成像 动脉自旋标记 

分 类 号：R816.3[医药卫生—放射医学]