摘要
目的探讨脑CT灌注成像在早期重型颅脑损伤患者中的应用。方法收集该院外伤致重型颅脑损伤患者106例(观察组)以及同期轻型脑外伤60例(对照组),均于伤后24 h内进行头颅256排CT灌注成像检查,并比较两组的脑血流灌注率(CBF)、脑血容量(CBV)和平均通过时间(MTT)及3个月后的预后情况等。结果观察组伤后24 h内脑基底节区、脑干、额叶、顶叶CBF低于对照组,MTT高于对照组,差异均有统计学意义(P<0.05)。基底节、脑干区、额叶、顶叶区CBF与格拉斯哥预后量表(GOS)评分呈正相关(rs=0.902,rs=0.891,rs=0.859,rs=0.786)。基底节丘脑区CBV与GOS评分有关。结论重型颅脑损伤患者早期的CBF值下降,MTT值延长,且CBF值与预后呈正相关,全脑CT灌注成像对早期判断重型颅脑损伤预后有一定临床应用价值。
Objective To investigate the application of whole-brain CT perfusion imaging in patients in early stage of severe traumatic brain injury.Methods A total of 106 patients with severe traumatic brain injury caused by trauma who were treated in our hospital were enrolled as observation group,and 60 patients with mild brain trauma were enrolled as control group.All patients underwent 256-slice whole-brain CT perfusion imaging within 24 hours after injury,and the two groups were compared in terms of cerebral blood flow(CBF),cerebral blood volume(CBV),mean transit time(MTT),and prognosis after 3 months.Results Compared with the control group,the observation group had significantly lower CBF values of the basilar ganglia,brainstem,frontal lobe,and parietal lobe and a significantly higher MTT within 24 hours after injury(all P <0.05).The CBF values of the basilar ganglia,brainstem,frontal lobe,and parietal lobe were positively correlated with Glasgow Outcome Scale(GOS) score(rs=0.902,0.891,0.859,and 0.786).CBV of the thalamus was associated with GOS score.Conclusion Reduction in CBF and prolongation of MTT are observed in patients in early stage of severe traumatic brain injury,and CBF value is positively correlated with prognosis.Whole-brain CT perfusion imaging has a certain clinical value in predicting the prognosis of patients with severe traumatic brain injury in the early stage.
作者
高灵
郑忠涛
韩奖励
王闯
陈伟明
GAO Ling;ZHENG Zhong-Tao;HAN Jiang-Li;WANG Chuang;CHEN Wei-Ming(Department of Neurosurgery,Central South University Xiangya School of Medicine Affiliated Haikou Hospital,Haikou,Hain-an 570208,China)
出处
《国际神经病学神经外科学杂志》
2021年第2期149-153,共5页
Journal of International Neurology and Neurosurgery
关键词
重型颅脑损伤
脑CT灌注成像
脑血流量
脑血容量
severe traumatic brain injury
whole-brain CT perfusion imaging
cerebral blood flow
cerebral blood volume
