CT灌注成像对颅脑损伤术后脑微循环障碍的早期诊断价值

目的探讨重型颅脑损伤术后CT灌注成像在评价脑微循环方面的应用价值。方法选择12例颅脑损伤患者在术后6～20h内行常规CT和CT灌注成像检查。结果早期常规头颅CT平扫，除颅脑损伤征象和术后改变外，无缺血表现7例；脑实质低密度缺血灶5例，占41．67％。11例患者的灌注参数图像[局部脑血流量（rCBF）、局部脑血容量（rCBV）、平均通过时间（MTT）]都有明确的异常表现，占91．67％，1例无变化。结论灌注CT能够在重型颅脑损伤术后早期显示脑组织灌注部位、范围及缺血程度，确定脑梗死的存在及灌注情况，并可进行定量研究，对临床早期选择预防脑梗死治疗方案具有一定的指导价值。可以作为指导治疗的一个指标。但受到病人病情、扫描时间、影像技术人员技术水平的影响。

The value of CT perfusion imaging in the diagnoses of cerebral microcirculation disturbance after early traumatic brain injury

Objective To evaluate the role of CT perfusion imaging(CTPI)for patients with cerebral microcirculation disturbance after early traumatic brain injury.Methods Regular CT and CTPI examinations were performed 6-20 hours after intracranial operation in 12 cases of traumatic brain injury.Results Ischemic lesions were found in 5 of 12 cases(41.67%)in regular CT imaging.However,abnormal local cerebral blood flow(rCBF),regional cerebral blood volume(rCBV)and mean transit time(MTT)revealed 11 of 12 cases(91.67%)in CT perfusion imaging.Conclusion We have experimentally demonstrated that the location and extent of cerebral ischemia could be accurately assessed by CTPI after early traumatic brain injury.The quantitative study of infarctions can be performed with CTPI.Therefore,CPTI is valuable in the prevention and treatment of cerebral infarction.But CTPI is also affected by the state of illness,scan time and technical level of technician.