CTPI观察高血压脑出血患者脑血流动力学对治疗及预后的评估价值

Value of CTPI Observing Hemodynamics in the Evaluation of the Treatment and Prognosis of Patients with Hypertensive Cerebral Hemorrhage

目的探讨多层螺旋CT灌注成像(CTPI)监测高血压脑出血患者脑血流动力学对治疗及预后的评估价值。方法选取2014年3月-2015年4月于我院接受治疗的34例高血压脑出血患者为研究对象,均于急性期和治疗15d时行CT平扫和CTPI检查。记录不同时间段血肿中心区、边缘区和外层区三处位置的脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)和达峰时间(TTP)差异,分析CTPI检测对患者临床疗效及预后情况的评估意义。结果急性期内,血肿及周围组织的血流动力学指标对比均有统计学意义(P<0.05);其中,血肿中心区急性期CBV、CBF、MTT水平均显著低于血肿边缘区及血肿外层区,差异有统计学意义(P<0.05);三处观察区域急性期TTP水平对比无统计学意义(P>0.05)。结论 CTPI检测可准确区分高血压脑出血患者的血肿病灶,在临床疗效和预后评估中发挥积极作用,利于医师掌握患者病情发展动态,确保治疗工作的顺利开展。

Objective To explore the value of multi-slice spiral CT perfusion imaging （CTPI） in monitoring cerebral hemodynamics in evaluation of the treatment and prognosis of patients with hypertensive cerebral hemorrhage. Methods 34 patients with hypertensive cerebral hemorrhage who were treated in our hospital between March 2014 and April 2015 were selected as study object. All underwent CT scan and CTPI examination in acute stage and on the 15th day of treatment. The differences in cerebral blood vohnne （CBV）, cerebral blood flow （CBF）, mean transit time （MTT） and time to peak （TTP） in the central area, the marshal area and the outer area of hematomas at different time points were recorded. The significance of CTPI detection in evaluation of clinical outcomes and prognosis of patients was analyzed, Results In the acute stage, the differences in hemodynamic indexes of hematomas and the surrounding tissues were statistically significant （P〈0.05）. The CBV, CBF and MTT levels in central area of hematomas in acute stage were significantly lower than those in the marginal zone and outer area of hematomas （P〈0.05）. There were no statistically significant differences in TTP levels between the three observation areas in acute phase （P〉0.05）.Conclusion CTPI detection can accurately distinguish the hematoma lesions in patients with hypertensive cerebral hemorrhage and it plays a positive role in the evaluation of clinical curative effect and prognosis, which is conductive to doctors mastering the dyuamic development of the disease and ensuring smooth development of the treatment.