CT灌注成像对急性颅脑外伤动态变化的诊断价值研究

Diagnostic Value of CT Perfusion Imaging in Dynamic Changes of Acute Traumatic Brain Injury

目的研究CT灌注成像(CTPI)对急性颅脑外伤(TBI)动态变化的诊断价值。方法选择本院2017年5月至2018年7月诊治的90例急性颅脑外伤患者作为研究对象,对患者进行普通CT检查以及CTPI检查,并于7d后进行复查,回顾性分析患者临床资料以及检查数据,比较两种检查方法的诊断价值。结果 CTPI对于脑挫裂伤、脑内血肿、硬膜下血肿和蛛网膜下腔出血检出率明显高于常规CT(P<0.05),两者在硬膜外血肿中的检出率比较无明显差异(P>0.05);病灶出血核心区的rCBV和rCBF与镜像区相比明显降低,MTT显著延长(P<0.05);病灶周围低密度区rCBV、rCBF和MTT也有所降低或延长,但总体趋势小于核心区(P<0.05),病灶周边正常密度区灌注参数与镜像区比较无显著差异(P>0.05);与CT2同时获得的CBV、CBF伪彩图显示的脑损伤面积与CT3-致性较好,明显高于CT1和CT2(P<0.05)。结论 CTPI应用于TBI诊断可显著提高诊断准确率,同时可通过血流灌注参数的变化更早、更准确地显示脑损伤病灶的范围以及程度。

Objective To study diagnostic value of CT perfusion imaging(CTPI)in dynamic changes of acute traumatic brain injury(TBI).Methods Ninety patients with acute TBI who were diagnosed and treated in the hospital from May 2017 to July 2018 were enrolled as study objects.All underwent general CT examination and CTPI examination.And they were reviewed 7d later.The clinical data and examination data were retrospectively analyzed.The diagnostic value of the two examination methods was compared.Results The detection rates of CTPI for cerebral contusion,intracerebral hematoma,subdural hematoma and subarachnoid hemorrhage were significantly higher than those of routine CT(P<0.05).There was no significant difference in detection rate of epidural hematoma between the two methods(P>0.05).The rCBV and rCBF in core area of lesion hemorrhage were significantly lower than those in mirror area,while MTT was significantly longer(P<0.05).The rCBV,rCBF and MTT in low-density area around lesions were decreased or prolonged,smaller than those in core area(P<0.05).There were no significant differencesin perfusion parameters between normal density area around lesions and mirror area(P>0.05).The showed brain damage areas by CBV and CBF pseudo-color images were well consistent with those by CT3,significantly higher than those by CT1 and CT2(P<0.05).Conclusion The application of CTPI in diagnosis of TBI can significantly improve diagnosisaccuracy.The scope and degree of brain injury lesions can be displayed earlier and more accurately through changes in blood perfusion parameters.