实验性急性脑梗死CT灌注成像对血管表面通透性与继发出血的相关性研究

目的：探讨急性脑梗死CT灌注成像中血管表面通透性（PS）参数变化与继发出血（HT）的相关性。方法：75只兔颈内动脉注射自体血栓制作急性脑梗死模型,证实脑梗死的动物3～72h依次行多层螺旋CT灌注成像并获得PS图。采用欧洲急性中风合作研究方法对病理证实的HT进行分型。应用SPSS11.5统计学软件比较无HT与不同程度HT组之间PS差异及PS值增加幅度与HT发生的相关性。结果：59只（78.67%）动物模型制作成功,其中无HT组21只（35.59%,21/59）、HI组31只（52.54%,31/59）、PH组7只（11.87%,7/59）。各组脑梗死区PS值升高均以3h最明显,此后逐渐下降。非HT组与HT组3h、6h、12h及48h、72h病变区PS值均有明显差异（P=0.000～0.010）,24hHT组PS值与非HT组无明显统计学差别（P=0.093）。PH组3～12h病变区PS值明显高于HI组（P=0.019～0.030）,24～72h两组之间的差别均无统计学意义（P〉0.05）。6h、12h、48h及72hPS与HT的有无及程度明显相关,Spearman秩相关系数为0.718～0.805（P=0.004～0.000）;3h及24h时间点二者仅为中度相关,Spearman秩相关系数为0.564及0.553（P=0.000及0.014）。结论：脑梗死急性期PS与HT的发生存在着较明显的正相关,原因可能是HT组微血管结构破坏更显著。

CT perfusion imaging in studying the relationship between permeability surface and secondary hemorrhage in acute cerebral infarction:an experimental study

Objective： To investigate the correlation between permeability surface （PS） parameters from muhislice CT perfusion imaging （CTP） and hemorrhagic transformation （HT） after acute experimental cerebral infarction Methods： Autologous thrombus was injected into unilateral internal carotid arteries of 75 rabbits to set up acute cerebral infarction model. When infarction was comfirmed by MR imaging at 3 hours after operation, CTP in coronal plane was made from 3h to 72h after cerebral infarction. PS images were calculated at workstation by using software of Perfusion 3. The HT of cerebral infarct animals were classified into hemorrhagic infarction （HI） group and parenchymal hematoma （PH） group according to the method of European-Australasian acute stroke study （ECASS）. The difference between the PS value of non-HT and various HT, and the Spearman correlation between PS and the degree of HT were assessed by using SPSS 11.5 software. Results： Cerebral ischemic model was successfully set up in 59 rabbits（78.67%）. No pathologic findings of HT was found in 21 animals（35.59%, 21/59）. Thirty-eight rabbits（64.41%, 38/59） which had HT included 31 rabbits（52.54%, 31/59） with HI and 7（11.87%, 7/59） with PH. After the peak of infarction lesions at 3h, PS decreased gradually. There was significant difference between the PS value of non-HT and HT groups at every time point （P=0.000-0.010） except at 24h （P=0.093）. PS values of PH group were higher than that of HI rabbits from 3h to 12h （P=0.019-0.030）, whereas there was no obvious difference between them from 24h to 72h （p〉0.05）. There was obvious correlation between PS and HT at 6h, 12h, 48h and 72h with the Spearman correlation from 0.718 to 0.805（P=-0.004-0.000）. Only moderate correlation was found between 3h and 24h, with the Spearman correlation of 0.564 and 0.553（p=-0.000 and P=0.014）. Conclusion： PS of acute cerebral infarction has considerable correlation with HT, probably because of the prominent di