CT脑灌注成像评价创伤弥漫性脑肿胀非手术治疗前后脑血流动力学改变.docVIP

CT脑灌注成像评价创伤弥漫性脑肿胀非手术治疗前后脑血流动力学改变 　　[摘要]目的 探讨64排螺旋CT在创伤弥漫性脑肿胀患者非手术治疗中的应用价值。方法 对我院2013年6月～2015年5月收治的经非手术治疗单纯弥漫性性脑肿胀患者100例，在伤后2～6 h内行CT灌注（CTP）检查，7 d后复查CTP，分析治疗前后感兴趣区域灌注参数的变化，6个月后随访，结合临床预后对数据进行统计、分析。结果 非手术治疗后，各感兴趣区域脑血流量（CBF）、脑血流容积（CBV）及平均通过时间（MTT）均较治疗前有所改善（P3分者改善明显。结论 CTP可快速、准确地反映DBS患者脑血流动力学变化，为临床早期治疗、判断预后提供更可靠的依据 [关键词]CT灌注成像；弥漫性脑肿胀；CBF；CBV；MTT [中图分类号] R651.1+9 [文献标识码] A [文章编号] 1674-4721（2016）12（b）-0025-04 Evaluation on cerebral hemodynamic changes before and after the non-surgical treatment for patients with traumatic diffuse brain swelling under CT perfusion imaging ZHANG Ke1 LIU Shao-guang1 ZHANG Jian-hua2 WEI Xiao-dong1 ZHANG Dong-zhi1 1.Department of Emergency，Gansu People′s Hospital，Lanzhou 730000，China；2.Department of Function，Lanzhou Pulmonary Hospital，Lanzhou 730050，China [Abstract]Objective To study the application value of 64-slice spiral CT in the non-surgical treatment for patients with traumatic diffuse brain swelling.Methods 100 patients with simple diffuse brain swelling were given non-surgical treatment in our hospital from June 2013 to May 2015，and they were selected and given CTP examination within 2 to 6 hours after injury，and CTP was reexamined after 7 days.The change of perfusion parameters in the region of interest before and after the treatment was analyzed.After 6 months patients were followed-up，the data was analyzed statistically with the clinical prognosis.Results After the non-surgical treatment，the CBF，CBV and MTT in the every region of interest were improved compared with those before treatment （P3 points were significantly improved.Conclusion CTP can reflect the cerebral hemodynamic changes in the patients with BDS rapidly and accurately，so as to provide reliable evidences for early treatment and determining the prognosis. [Key words]CT perfusion imaging；Diffuse brain swelling；CBF；CBV；MTT ??漫性脑肿胀（diffuse brain swelling，DBS）是弥漫性脑损伤（diffuse brain injury，DBI）分型中最重要的一类，其发生机制早期是由于脑充血、脑水肿所致，大部分4 h左右，少数半小时内随着颅内压的进一步升高，局部脑血