CT灌注成像对高血压性脑出血患者亚急性期血肿量的评估价值

Value of CT perfusion to predicting subacute hematoma volume in patients with hypertensive cerebral hemorrhage

目的探讨CT灌注成像参数对高血压性脑出血(hypertensive cerebral hemorrhage,HCH)患者亚急性期血肿量的相关性。方法 HCH亚急性期患者100例,均行CT灌注成像检测血肿区及对称健侧区血流量、平均通过时间、血容量、表面通透性等灌注参数,并依据血肿量分为低量组(5～30mL)40例和中量组(>31～60mL)60例,比较2组CT灌注参数;采用Pearson相关性分析CT灌注参数与血肿量的关系。结果 HCH亚急性期患者血肿区血流量[(9.62±1.58)mL/(min·100g)]、血容量[(1.06±0.12)L/g]明显低于对称健侧区[(26.34±3.12)mL/(min·100g)、(1.88±0.20)L/g],平均通过时间[(11.27±1.24)s]、表面通透性[(2.14±0.22)mL/(min·100g)]明显高于对称健侧区[(5.42±0.56)s、(1.19±0.14)mL/(min·100g)](P<0.05);中量组血肿区血流量[(8.60±0.94)mL/(min·100g)]、血容量[(0.86±0.10)L/g]明显低于低量组[(11.14±1.26)mL/(min·100g)、(1.35±0.16)L/g],血肿区平均通过时间[(12.26±1.38)s]、表面通透性[(2.33±0.26)mL/(min·100g)]明显高于低量组[(9.78±1.04)s、(1.85±0.20)mL/(min·100g)](P<0.05);血流量、血容量与血肿量呈负相关(r=-0.821,P<0.001;r=-0.836,P<0.001),平均通过时间、表面通透性与血肿量呈正相关(r=0.811,P<0.001;r=0.842,P<0.001)。结论 CT灌注成像中血流量、血容量、平均通过时间、表面通透性与HCH亚急性期患者血肿量有关,可作为评估患者病情的重要指标。

Objective To discuss the correlation between CT perfusion parameters and subacute hematoma volume in patients with hypertensive cerebral hemorrhage(HCH).Methods One hundred patients with subacute HCH underwent CT perfusion to detect the blood flow,mean transit time,blood volume and surface permeability in hematoma area and contralateral area.According to the hematoma volume,the patients were divided into 40 patients with hematoma volume of 5 to 30 mL(low volume group)and 60 patients with hematoma volume of 31 to 60 mL(medium volume group).The perfusion parameters were compared between two groups.The relationship between CT perfusion parameters and hematoma volume was analyzed by Pearson correlation analysis.Results The blood flow((9.62±1.58)mL/(min·100 g))and blood volume((1.06±0.12)L/g))in the hematoma area in patients with subacute HCH were significantly lower than those in the contralateral area((26.34±3.12)mL/(min·100 g),(1.88±0.20)L/g),and the mean transit time((11.27±1.24)s)and surface permeability((2.14±0.22)mL/(min·100 g))in the hematoma area in patients with subacute HCH were significantly higher than those in the contralateral area((5.42±0.56)s,(1.19±0.14)mL/(min·100 g))(P<0.05).The blood flow((8.60±0.94)mL/(min·100 g))and blood volume((0.86±0.10)L/g)in the hematoma area in medium volume group were significantly lower than those in low volume group((11.14±1.26)mL/(min·100 g),(1.35±0.16)L/g),and the mean transit time((12.26±1.38)s)and surface permeability((2.33±0.26)mL/(min·100 g))in the hematoma area in medium volume group were significantly higher than those in low volume group((9.78±1.04)s,(1.85±0.20)mL/(min·100 g))(P<0.05).Blood flow and blood volume were negatively correlated with hematoma volume(r=-0.821,P<0.001;r=-0.836,P<0.001),and mean transit time and surface permeability were positively correlated with hematoma volume(r=0.811,P<0.001;r=0.842,P<0.001).Conclusion Blood flow,blood volume,mean transit time and surface permeability in CT perfusion are correlated with hematoma volume in patients with subacute HCH,and can be used as the important parameters for evaluating the condition of patients.