高血压性脑出血局部组织血流量变化的CT灌注研究

目的 利用CT灌注成像的方法探讨高血压脑出血血肿周围及其远隔区域脑血流变化情况。方法 对20例高血压脑出血患者行治疗后2周颅脑CT灌注扫描及计算机辅助系统制作颅脑CT灌注参数图,对血肿周围局部脑血流量（regional cerebral blood flow，rCBF）、局部脑血容量（regional cerebralblood volume，rCBV）和对比剂平均通过时间（mean transit time，MTT）脑血流动力学参数进行定量测量，并与正常侧对应参照点进行比较。结果 血肿周围存在不同程度低灌注，血肿边缘区rCBF、rCBV显著低于血肿外层区,血肿边缘区MTT较血肿外层区明显延长（P <0.05），血肿边缘区及外层区rCBF、rCBV、MTT较相应镜像点均有统计学差异（P <0.05）。结论 血肿周围局部脑血流显著降低，CT灌注成像可显示血肿周围异常的脑血流动力学变化, 可为脑出血临床救治提供有价值信息。

Study of CT Perfusion Imaging in Cerebral Blood Flow of Hypertensive Cerebral Hemorrhage

Objective To observe hemodynamic alteration of the perihematomal and the remote brain region in hypertensive cerebral hemorrhage patients with CT perfusion imaging. Methods CT perfusion imaging was performed after two weeks treatment in 20 hypertensive cerebral hemorrhage patients. Computer-aided system was used to produce CT perfusion parameters map. The parameters regional cerebral blood flow （rCBF）, regional cerebral blood volume （rCBV） and mean transit time （MTT） were measured and compared with the corresponding point of the contralateral hemisphere for reference. Results There were diverse degree of hypoperfusion in perihematomal region against contralateral hemisphere. The rCBF and rCBV adjaneent to the hematomas were lower than those of outer region,and MTT significantly longer（P〈0.05）. The rCBF, rCBV and MTT of adjancent to the hematomas and outer region were significantly different from those of mirror points （P〈0.05）. Conclusion There was significantly decreased cerebral blood flow in perihematomal region. CT perfusion imaging could clearly demonstrate the abnormal cerebral hemodynamic change occurred in the region surrounding the hematoma and could provide valuable information to the clinical treatment after cerebral hemorrhage.