CTP联合CTA对颅脑创伤病灶周围组织血流灌注的评估价值  

Evaluated Value of CTP Combined with CTA on Blood Perfusion in the Surrounding Tissue of Traumatic Brain Injury Lesions

作　　者：郑颖[1] 许兵强 陈小龙[1] 张艳[1] 寇明清[1] ZHENG Ying;XU Bing-qiang;CHEN Xiao-long;ZHANG Yan;KOU Ming-qing(Department of Radiology,Shaanxi Provincial People's Hospital,Xi'an 710068,Shaanxi Province,China)

机构地区：[1]陕西省人民医院医学影像中心,陕西西安710068

出　　处：《中国CT和MRI杂志》2024年第9期20-22,共3页Chinese Journal of CT and MRI

基　　金：陕西省重点研发计划项目(2021SF-377)。

摘　　要：目的CT灌注成像(CTP)联合CT血管成像(CTA)对颅脑创伤(TBI)病灶周围组织血流灌注的评估价值。方法回顾性分析我院80例TBI患者资料。所有患者均行CTP、CTA及数字减影血管造影术(DSA)检查,以手术病理及DSA为“金标准”,比较CTP和CTA对患者病灶的检出情况、病灶区和对侧区CTP参数[脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)、达峰时间(TTP)]值,分析CTA对TBI患者病灶周围血管狭窄程度的检出情况,采用Pearson相关系数分析CTP参数与GCS评分的相关性。结果80例患者中经手术病理诊断颅内损伤42例,轴外损伤28,颅脑深部损伤10例,CTP和CTA的临床检出率分别为96.25%、93.75%;病灶区CBV、CBF值均显著低于对侧区(P<0.05),MTT、TTP值均显著高于对侧区(P<0.05);80例患者经DSA诊断共检出89处血管狭窄,其中轻度狭窄45处,中度狭窄26处,重度狭窄15处,闭塞3处,CTA检测轻度中度、重度和闭塞血管的准确率分别为97.73%、82.14%、85.71%、100%,总准确率为91.01%;Pearson相关系数分析显示,GCS评分与CTP参数CBF、CBV呈显著正相关,与MTT、TTP呈显著负相关(P<0.05)。结论应用CTP和CTA可以较好地反馈TBI患者颅脑血流动力学和血管病变情况,两者联合检查可以为TBI患者临床诊断提供重要信息,以辅助临床治疗。Objective To explore the evaluated value of CT perfusion imaging(CTP)combined with CT angiography(CTA)on blood perfusion in the surrounding tissues of traumatic brain injury(TBI)lesions.Methods The data of 80 patients with TBI in our hospital were analyzed retrospectively.CTP,CTA and digital subtraction angiography(DSA)were performed on all patients,the surgical pathology and DSA were used as the gold standard,and the detection status of lesions by CTP and CTA and CTP parameters[cerebral blood flow(CBF),cerebral blood volume(CBV),mean transit time(MTT),time to peak(TTP)]in lesion area and contralateral area were compared.The detection status of lesion surrounding vascular stenosis degree in patients with TBI by CTA was analyzed,and Pearson correlation coefficient was used to analyze the correlation between CTP parameters and GCS score.Results Among the 80 patients,there were 42 cases of intracranial injury,28 cases of extraaxial injury and 10 cases of deep brain injury by surgical pathological diagnosis.The clinical detection rates of CTP and CTA were 96.25%and 93.75%respectively.The CBV and CBF in the lesion area were significantly lower than those in the contralateral area(P<0.05),and the MTT and TTP were significantly longer than those in the contralateral area(P<0.05).89 sites of vascular stenosis were detected in 80 patients diagnosed by DSA,including 45 mild stenosis,26 moderate stenosis,15 severe stenosis and 3 occlusion.The accuracy rates of mild,moderate,severe and occlusive vessels detected by CTA were 97.73%,82.14%,85.71%and 100%respectively,with a total accuracy rate of 91.01%.Pearson correlation coefficient analysis showed that GCS score were positively correlated with CTP parameters CBF and CBV,and were negatively correlated with MTT and TTP(P<0.05).Conclusion CTP and CTA can better feedback the cranial hemodynamics and vascular lesions in patients with TBI.The combined examination of CTP and CTA can provide important information for the clinical diagnosis of patients with TBI to assist clinical tre

关 键 词：CT灌注成像 CT血管成像 颅脑创伤 血流灌注 

分 类 号：R651.15[医药卫生—外科学]