CT灌注成像联合平均动脉压对重型脑外伤脑卒中的诊断价值  

The Diagnostic Value of CT Perfusion Imaging Combined With Mean Arterial Pressure in Severe Traumatic Stroke

作　　者：李延皎[1] 李超[1] 刘志鹏[1] 张竞睿 范洁[1] LI Yanjiao;LI Chao;LIU Zhipeng;ZHANG Jingrui;FAN Jie(CT Room,Heilongjiang Provincial Hospital,Harbin Heilongjiang 150036,China)

机构地区：[1]黑龙江省医院CT室,黑龙江哈尔滨150036

出　　处：《中国卫生标准管理》2023年第8期85-89,共5页China Health Standard Management

基　　金：黑龙江省卫生健康委科研课题(20210909010231);黑龙江省卫生健康委科研课题(20210909020117)。

摘　　要：目的运用多层螺旋CT灌注成像联合平均动脉压在重型颅脑损伤脑卒中的应用效果。方法选取2020年11月—2022年9月于黑龙江省医院神经外科住院治疗的重型颅脑外伤患者63例,随机分为三组,每组21例。采用不同扫描方法分为平扫组、灌注组及联合组。平扫组复查时采用常规CT平扫,灌注组采用CT灌注扫描,联合组选用CT颅脑灌注联合平均动脉压的方法。分别对三组患者治疗后1、3个月的格拉斯哥昏迷指数评分(Glasgow coma score,GCS评分)进行比较;对灌注组及联合组治疗后1、3个月的CT灌注参数情况进行对比;比较诊断灵敏度及特异度,绘制ROC曲线,评价联合组的诊断价值。结果治疗前三组患者GCS评分差异无统计学意义(P>0.05);治疗后三组GCS评分均有上升,治疗后1个月后联合组评分最高(P<0.05),治疗后6个月比较差异无统计学意义(P>0.05);治疗1个月后,联合组脑血流量(cerebral blood flow,CBF)、脑血容量(cerebral blood volume,CBV)均低于灌注组、联合组平均通过时间(mean transit time,MTT)较灌注组长,以上差异均有统计学意义(P<0.05)。治疗后6个月两组CBF、CBV、MTT差异均无统计学意义(P>0.05);联合组诊断灵敏度高于平扫组和灌注组(P<0.05)。结论CT灌注成像联合平均动脉压相较于其他单一检查对于重型颅脑外伤患者的诊断准确性高,值得于临床中推广使用。Objective To evaluate the effect of multi-slice spiral CT perfusion imaging combined with mean arterial pressure in severe brain injury and stroke.Methods A total of 63 patients with severe craniocerebral injury hospitalized in the neurosurgery department of Heilongjiang Provincial Hospital from November 2020 to September 2022 were selected and randomly divided into three groups,a total of 21 patients in each group,divided into plain scan group,perfusion group and combined group by different scanning methods.In the plain scan group,routine CT plain scan was used for re-examination;CT perfusion scanning was used in perfusion group;In the combined group,CT craniocerebral perfusion combined with mean arterial pressure was used.The Glasgow coma score(GCS score)of the three groups of patients were compared 1 month and 3 months after treatment.The CT perfusion parameters of the perfusion group and the combination group were compared 1 month and 3 months after treatment;The diagnostic sensitivity and specificity were compared,the ROC curve was drawn,and the diagnostic value of the combined group was evaluated.Results There was no statistical difference in GCS scores among the three groups before treatment(P>0.05).After treatment,the GCS scores of the three groups were all increased.The score of the combined group was the highest one month after treatment(P<0.05).There was no significant difference after 6 months of treatment(P>0.05).After 1 month of treatment,the cerebral blood flow(CBF)and cerebral blood volume(CBV)of the combined group were lower than that of the perfusion group and the combined group,and the mean transit time(MTT)was significantly longer than that of the perfusion group.The above differences were statistically significant(P<0.05).There were no statistically significant in CBF,CBV,MTT between the two groups after 6 months of treatment(P>0.05).The diagnostic sensitivity of combined group was higher than that of plain scan group and perfusion group(P<0.05).Conclusion Compared with other single examinati

关 键 词：CT灌注 颅脑外伤 平扫 平均动脉压 GCS评分 脑血流流量 脑血流容量 平均通过时间 

分 类 号：R651[医药卫生—外科学]