CT灌注成像对脑积水分流手术疗效判断的研究  

Study on CT Perfusion Imaging in Evaluating the Curative Effect of Hydrocephalus Shunt Operation

作　　者：陈志贺 高寒 陈志生 郭锐 Chen Zhihe(Yunfu People’s Hospital,Yunfu Guangdong 527300)

机构地区：[1]云浮市人民医院,广东云浮527300

出　　处：《黑龙江医药》2022年第6期1260-1263,共4页Heilongjiang Medicine journal

基　　金：云浮市医学科学技术研究立项(项目编号:2021B011)。

摘　　要：目的:探讨CT灌注成像在脑积水分流手术疗效评估中的应用价值。方法:选择2021年6月至2022年1月于我院治疗的70例继发性脑积水高危因素患者纳入研究,根据患者最终是否出现脑积水,将所有研究对象分为脑积水组(n=37)和无脑积水组(n=33),对两组患者进行CT灌注成像(CTP)检查,比较两组各脑区相应检查数据。针对脑积水组患者开展分流手术治疗,术后复查CTP,比较分流效果较好的脑积水患者术前与术后各脑区相应检查数据,参考所得数据分析CTP对脑积水分流手术疗效判断效果与价值。结果:两组患者侧脑室前角rCBV、rMTT及rTTP,额叶、颞叶、枕叶与基底区rCBF、rCBV、rMTT及rTTP比较无差异(P>0.05);脑积水组侧脑室前角rCBF低于无脑积水组(P<0.05);分流效果较好脑积水患者手术前后额叶、颞叶、枕叶与基底区灌注值比较无差异(P>0.05);手术治疗后本组患者侧脑室前角rCBF高于治疗前(P<0.05)。结论:CTP检查中侧脑室前角RCBF可一定程度预测患者脑积水发生风险,且对手术治疗及疗效评估具有较好的指导价值。Objective:To explore the application value of CT perfusion imaging in the evaluation of therapeutic effect of hydrocephalus shunt surgery.Methods:A total of 70 patients with high risk factors for secondary hydrocephalus who were treated in our hospital from June 2021 to January 2022 were included in the study.According to whether hydrocephalus eventually occurred,all subjects were divided into hydrocephalus group(n=37)and no hydrocephalus group(n=33),and CT perfusion imaging(CTP)examination was performed on both groups.The corresponding examination data of each brain area were compared between the two groups.The patients in the hydrocephalus group were treated with shunt surgery,and CTP was reviewed after surgery.The corresponding examination data of each brain area in the hydrocephalus patients with better shunt effect were compared before and after surgery,and the effect and value of CTP on the curative effect of hydrocephalus shunt surgery were analyzed by referring to the obtained data.Results:There were no differences in rCBV,rMTT and rTTP in the anterior corner of the lateral ventricle,rCBF,rCBV,rMTT and rTTP in the frontal lobe,temporal lobe,occipital lobe and basal area between the two groups(P>0.05).rCBF of anterior horn of lateral ventricle in hydrocephalus group was lower than that in no hydrocephalus group(P<0.05).There was no difference in perfusion values of frontal lobe,temporal lobe,occipital lobe and basal area before and after operation in patients with hydrocephalus with better shunt effect(P>0.05).After surgical treatment,rCBF of anterior horn of lateral ventricle was higher than that before treatment(P<0.05).Conclusion:The rCBF of the anterior horn of the middle ventricle can predict the risk of hydrocephalus to a certain extent,and has a good guiding value for surgical treatment and efficacy evaluation.

关 键 词：CT灌注成像 脑积水 分流手术 疗效评估 

分 类 号：R742.7[医药卫生—神经病学与精神病学]