CT灌注成像评价颅骨缺损修复前后脑血流量变化的临床研究(1)
摘 要：目的 通过CT灌注成像(CTP)观察颅骨成形术患者脑血流量的变化。方法 对20例颅骨缺损修复的患者进行脑CT灌注成像，在颅骨修复术前和术后2周进行CTP。记录大脑皮层、基底节区脑血流容量(CBV)、脑血流流量(CBF)、造影剂平均通过时间(MMT)和对比剂达到峰值的时间(TTP)等所有参数，分析脑皮层和基底节区血流灌注数据的变化。结果 颅骨修复术前患侧脑皮层区的CBV和CBF值均低于健侧，TTP和MTT值均高于健侧，差异均具有统计学意义(P<0.05)。修复术后患侧脑皮层的CBF、CBV值均有提高，患侧脑皮层的MTT、TTP值较术前降低，差异均具有统计学意义(P<0.05)。患侧术后脑皮层的CBV、CBF、MTT、TTP值与健侧比较无统计学意义(P>0.05)。结论 CT灌注成像能及时发现脑血流变化情况，颅骨修复可以增加脑皮层区脑血流量，促进神经功能恢复。
关键词：颅骨修补术；CT灌注成像；脑血流量
中图分类号：R651.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.10.029
, 百拇医药
文章编号：1006-1959(2018)10-0096-03
Clinical Study of CT Perfusion Imaging in Evaluating Cerebral Blood Flow before and after Repair of Skull Defect
LU Ping，MENG Qing-heng，GAO Wei
(Department of Neurosurgery，Ocean Petroleum General Hospital，Tianjin 300452，China)
Abstract：Objective To observe the changes of cerebral blood flow in patients undergoing cranioplasty by CT perfusion imaging (CTP).Methods Cerebral CT perfusion imaging was performed in 20 patients with skull defect，and CTP was performed before and 2 weeks after cranioplasty.The cerebral cortex and basal ganglia cerebral blood flow volume(CBV)，cerebral blood flow(CBF)，contrast agent average passing time(MMT)and contrast agent reaching the peak time(TTP)were recorded，and the changes of cerebral cortex and basal ganglia blood perfusion data were analyzed.Results The values of CBV and CBF in the cortex of the affected side were lower than those of the healthy side before cranioplasty.The values of TTP and MTT were all higher than those of the healthy side，and the differences were statistically significant(P<0.05).After the repair，the CBF and CBV values of the cerebral cortex were improved，and the MTT and TTP values of the affected cortex were lower than those before the operation，and the difference was statistically significant(P <0.05).The values of CBV，CBF，MTT and TTP in the cortex of the affected side were not statistically significant compared with those on the contralateral side(P>0.05).Conclusion CT perfusion imaging can detect the change of cerebral blood flow in time.Cranioplasty can increase cerebral blood flow and promote neurological function recovery.
, http://www.100md.com
Key words：Cranioplasty；CT perfusion imaging；Cerebral blood flow
顱骨缺损修补术是临床治疗颅脑外伤的常用术式。研究发现[1]，部分颅骨修补术后患者的神经功能障碍较术前有明显改善或恢复。关于颅骨修补术改善神经功能的作用机制众说纷纭。为此，我们使用目前在测量脑血流量方面较常应用的 CT灌注成像来探讨颅骨修补术前后脑血流的变化，从脑血流量变化方面探讨患者神经功能获得改善和恢复的可能机制。
1资料与方法
1.1一般资料 选取2013年1月～2015年1月在海洋石油总医院进行颅骨修补手术的患者20例，其中男14例，女6例；年龄38～76岁，平均年龄(47.20±7.53)岁；颅骨缺损面积5 cm×5 cm～10 cm×14 cm，平均面积7.2 cm×9.5 cm；颅骨修复距去骨瓣减压时间为5～12个月，平均时间(6.40±2.24)个月。, http://www.100md.com(路平 孟庆恒 高伟)
关键词：颅骨修补术；CT灌注成像；脑血流量
中图分类号：R651.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.10.029
, 百拇医药
文章编号：1006-1959(2018)10-0096-03
Clinical Study of CT Perfusion Imaging in Evaluating Cerebral Blood Flow before and after Repair of Skull Defect
LU Ping，MENG Qing-heng，GAO Wei
(Department of Neurosurgery，Ocean Petroleum General Hospital，Tianjin 300452，China)
Abstract：Objective To observe the changes of cerebral blood flow in patients undergoing cranioplasty by CT perfusion imaging (CTP).Methods Cerebral CT perfusion imaging was performed in 20 patients with skull defect，and CTP was performed before and 2 weeks after cranioplasty.The cerebral cortex and basal ganglia cerebral blood flow volume(CBV)，cerebral blood flow(CBF)，contrast agent average passing time(MMT)and contrast agent reaching the peak time(TTP)were recorded，and the changes of cerebral cortex and basal ganglia blood perfusion data were analyzed.Results The values of CBV and CBF in the cortex of the affected side were lower than those of the healthy side before cranioplasty.The values of TTP and MTT were all higher than those of the healthy side，and the differences were statistically significant(P<0.05).After the repair，the CBF and CBV values of the cerebral cortex were improved，and the MTT and TTP values of the affected cortex were lower than those before the operation，and the difference was statistically significant(P <0.05).The values of CBV，CBF，MTT and TTP in the cortex of the affected side were not statistically significant compared with those on the contralateral side(P>0.05).Conclusion CT perfusion imaging can detect the change of cerebral blood flow in time.Cranioplasty can increase cerebral blood flow and promote neurological function recovery.
, http://www.100md.com
Key words：Cranioplasty；CT perfusion imaging；Cerebral blood flow
顱骨缺损修补术是临床治疗颅脑外伤的常用术式。研究发现[1]，部分颅骨修补术后患者的神经功能障碍较术前有明显改善或恢复。关于颅骨修补术改善神经功能的作用机制众说纷纭。为此，我们使用目前在测量脑血流量方面较常应用的 CT灌注成像来探讨颅骨修补术前后脑血流的变化，从脑血流量变化方面探讨患者神经功能获得改善和恢复的可能机制。
1资料与方法
1.1一般资料 选取2013年1月～2015年1月在海洋石油总医院进行颅骨修补手术的患者20例，其中男14例，女6例；年龄38～76岁，平均年龄(47.20±7.53)岁；颅骨缺损面积5 cm×5 cm～10 cm×14 cm，平均面积7.2 cm×9.5 cm；颅骨修复距去骨瓣减压时间为5～12个月，平均时间(6.40±2.24)个月。, http://www.100md.com(路平 孟庆恒 高伟)