MSCT和CTPI在外伤性弥漫脑肿胀中应用效果对比.docVIP

MSCT和CTPI在外伤性弥漫脑肿胀中应用效果对比 　　[摘要]目的 比较颅脑多排螺旋CT（MSCT）和CT?X灌注成像（CTPI）在外伤性弥漫脑肿胀（DBS）中的应用效果。方法 选取2015年1月～2016年10月收治的100例DBS患者作为研究对象，使用GE light speed 64排螺旋CT机扫描，在伤后2～6 h内行常规MSCT检查和CTPI检查，72 h内再次复查CTPI。比较MSCT与CTPI的DBS检出率，分析脑血流量（CBF）、脑血容量（CBV）、平均通过时间（MTT）和超清彩色图像与DBS预后的关系。结果 MSCT对DBS的检出率为88.0%，低于CTPI的96.0%（P0.01）。治疗后，患者的CBF、CBV呈升高趋势，初次检查与复查CBF、CBV、MTT值比较，差异有统计学意义（P0.01）。结论 MSCT和CTPI在DBS中具有较好的应用效果，但CTPI能够有效评估患者的预后情况，通过超前彩色图像可直观观察和评价患者的病情变化，值得在临床中推广应用。 　　[关键词]多排螺旋CT；CT脑灌注成像；外伤性弥漫脑肿胀 　　[中图分类号] R816.1 [文献标识码] A [文章编号] 1674-4721（2017）03（a）-0145-03 　　[Abstract]Objective To compare the application effect of brain multi-slice spiral CT （MSCT） and CT perfusion imaging （CTPI） in evaluation of traumatic diffuse brain swelling （DBS）.Methods Altogether 100 cases of patients with DBS from January 2015 to October 2016 were selected as study object.All the patients were scanned by using GE light speed 64-slice spiral CT machine and underwent conventional MSCT and CTPI examinations at 2 to 6 hours after injury and CTPI re-examinations within 72 hours.The detection rate of DBS by using MSCT and CTPI were compared，cerebral blood flow （CBF），cerebral blood volume （CBV），mean transit time （MTT） and the relationship between ultra clear color images and prognosis of DBS were analyzed.Results The detection rate of DBS by using MSCT was 88.0%，significantly lower than that of CTPI （96.0%）（P0.01）；after treatment，CBF and CBV was increased，while MTT was decreased，the difference of CBF，CBV and MTT between initial examination and reexamination was statistically significant （P0.01）.Conclusion MSCT and CTPI have good application effect in evaluation of DBS，but CTPI can effectively assess the prognosis of patients.By using the color image，disease change can be directly evaluated and observed，which is worthy of clinical application. 　　[Key words]Multi-slice spiral CT；CT perfusion imaging；Traumatic diffuse brain swelling 　　随着我国现代化进程的高速发展，各类工业和交通事故等导致的人身伤害逐年增多，仅颅脑外伤（traumatic brain injury，TBI）的发生率100/10万[1