CT灌注成像评估颅脑损伤的程度及其对ICP探头置入术后脑血流动力学的预测价值  

CT Perfusion Imaging in Evaluating the Degree of Craniocerebral Injury and its Predictive Value for Cerebral Hemodynamics after ICP Probe Implantation

作　　者：杜彦挺 杜光勇 贾喆[1] 王晓溪[1] 贺利霞 DU Yan-ting;DU Guang-yong;JIA Zhe(Yulin Second Hospital,Yulin Shaanxi 719000)

机构地区：[1]榆林市第二医院,陕西榆林719000

出　　处：《医学临床研究》2023年第1期24-27,共4页Journal of Clinical Research

基　　金：榆林市科技计划项目(2014jh-24)。

摘　　要：[目的]探讨CT灌注成像评估颅脑损伤的程度及其对ICP探头置入术后脑血流动力学的预测价值.[方法]选择2016年1月至2020年12月本院收治的79例颅脑损伤患者(观察组),其中轻度患者25例,中度患者21例,重度患者33例.另选取同期进行健康体检者79例(对照组).比较观察组及对照组、不同严重程度颅脑损伤患者、不同疗效患者局部脑血流量(rCBF)、局部脑血容积(rCBV)、血液通过组织的平均时间(MTT).受试者工作特征(ROC)曲线分析rCBF、rCBV、MTT检测对颅脑损伤的严重程度以及治疗效果的预测价值.[结果]观察组rCBF、rCBV显著低于对照组,MTT显著高于对照组,差异有统计学意义(P<0.05).轻度组、中度组、重度组rCBF、rCBV呈逐渐下降的趋势,MTT呈升高趋势,且组间比较差异有统计学意义(P<0.05).有效组患者rCBF、rCBV高于无效组,MTT低于无效组,差异有统计学意义(P<0.05).ROC曲线分析显示,rCBF、rCBV、MTT联合检测对颅脑损伤的严重程度以及治疗效果的预测曲线下面积显著高于单独检测(P<0.05).[结论]CT灌注成像对脑损伤程度的诊断及其对ICP探头置入术后脑血流动力学的诊断特异度较高,值得临床推广应用.【Objective】To evaluate the degree of craniocerebral injury by CT perfusion imaging and its predictive value for cerebral hemodynamics after ICP probe implantation.【Methods】A total of 79 patients with craniocerebral injury(observation group)admitted to our hospital from January 2016 to December 2020 were selected,including 25 mild patients,21 moderate patients and 33 severe patients.In addition,79 patients(control group)were selected for physical examination at the same time.The levels of regional cerebral blood flow(rCBF),regional cerebral blood volume(rCBV)and mean time of blood passing through tissues(MTT)were compared between the observation group and the control group,patients with different severity and patients with different therapeutic effects.ROC curve was used to analyze the predictive value of rCBF,rCBV and MTT in the severity of brain injury and the therapeutic effect.【Results】The rCBF and rCBV in the observation group were significantly lower than those in the control group,and the MTT was significantly higher than that in the control group(P<0.05).The rCBF and rCBV of the mild group,the moderate group and the severe group showed a gradual increase trend,while MTT showed a downward trend,and the difference between the groups was statistically significant(P<0.05).The rCBF and rCBV of patients in the effective group were higher than those in the ineffective group,and the MTT was lower than those in the ineffective group(P<0.05).ROC curve analysis showed that the area under the prediction curve of the severity of brain injury and the therapeutic effect of the combined detection of rCBF,rCBV and MTT was significantly higher than that of the single detection(P<0.05).【Conclusion】CT perfusion imaging has high specificity in the diagnosis of brain injury and cerebral hemodynamics after ICP probe implantation,which is worthy of clinical application.

关 键 词：脑损伤/影像诊断 体层摄影术 螺旋计算机 血流动力学 颅内压 

分 类 号：R651.15[医药卫生—外科学]