CT脑灌注成像联合平均动脉压在重症颅脑外伤患者中的诊断价值及与预后的关系

Abstract
Figure/Table
References (22)
Related Citation (15)

Download: PDF (551 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To investigate the diagnostic value of CT perfusion imaging (CTP) combined with mean arterial pressure (MAP) in patients with severe craniocerebral trauma and its relationship with prognosis. Methods A total of 90 patients with severe suspected craniocerebral trauma who were admitted to the Department of Neurosurgery of the Third Hospital of Nanchang from April 2019 to February 2021 were selected as the research objects. All patients underwent routine head CTP examination after admission, and the final clinical examination results were used as "golden standard". The diagnostic value was analyzed and the MAP level was monitored. The patients were followed up for 6 months, and the Glasgow coma index score (GOS) was used as the prognostic scoring standard. The patients were evaluated at 1, 6 months after treatment, and the correlation analysis was completed. Results Among 90 patients with severe suspected craniocerebral trauma, 62 patients were finally diagnosed by clinical examination, with a diagnosis rate of 68.89%. 57 patients were finally diagnosed by head CTP examination, and the coincidence rate with the "gold standard" diagnosis was 85.56% [(53+24)/90]. The diagnostic sensitivity was 85.48% (53/62), the specificity was 85.71% (24/28). The levels of cerebral blood perfusion rate (CBF), cerebral blood volume (CBV) and MAP in severe craniocerebral trauma were lower than those in non-severe craniocerebral trauma, and the differences were statistically significant (P<0.05). The mean transit time (MTT) and the time to peak contrast (TTP) were longer than those of non-severe craniocerebral trauma, and the differences were statistically significant (P<0.05). The average GOS score of patients with severe craniocerebral trauma was (3.13±0.63). The results of correlation analysis showed that the GOS score of patients with severe craniocerebral trauma was negatively correlated with the levels of CBF, CBV and MAP, and positively correlated with MTT and TTP (P<0.05). Conclusion CTP has high diagnostic value in patients with severe craniocerebral trauma. Combined examination with MAP can guide clinical treatment and has a strong correlation with the prognosis of patients.

Key words： CT perfusion imaging Mean arterial pressure Severe craniocerebral trauma Diagnostic value Treatment prognosis Correlation analysis

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	LI Shiqing
	SONG Zengliang

Cite this article:

LI Shiqing,SONG Zengliang. Diagnostic value of CT perfusion imaging combined with mean arterial pressure in patients with severe craniocerebral trauma and its relationship with prognosis[J]. 中国当代医药, 2022, 29(19): 14-17.

URL:

https://www.dangdaiyiyao.com/EN/ OR https://www.dangdaiyiyao.com/EN/Y2022/V29/I19/14

[1]	张晓蕾，李莉，彭倩宜，等.感染性休克患者舌下微循环障碍分型及与预后的研究初探[J].中华内科杂志，2021，60（10）：898-903.
[2]	侯进，王伟，叶晖，等.能谱CT脑灌注成像和头颈CTA联合扫描定量评估颈动脉狭窄对脑内血流储备的影响[J].中国医学装备，2019，16（5）：15-18.
[3]	周凯，王延辉，秦晓雯，等.CT灌注成像在反映鼻咽癌放疗效果及预后评估中的可行性分析[J].中国CT和MRI杂志，2021，19（11）：29-31.
[4]	Andrews，Peter JD.Re：Intracranial pressure monitoring in severe traumatic brain injury[J].BMJ，2021，19（5）：497.
[5]	贺敬红，乔英，张华，等.全脑CT灌注联合4D-CTA对颞浅动脉-大脑中动脉搭桥术血流动力学的应用价值[J].中西医结合心脑血管病杂志，2019，17（11）：1732-1735.
[6]	邓磊，李依，冯璇璘，等.PCT和CRP在重症颅脑外伤合并呼吸机相关性肺炎中的诊断价值[J].中华医院感染学杂志，2020，30（11）：1713-1717.
[7]	Tas J，Beqiri E，van Kaam RC，et al.Targeting Autoregulation-Guided Cerebral Perfusion Pressure after Traumatic Brain Injury（COGiTATE）： A Feasibility Randomized Controlled Clinical Trial[J].J Neurotrauma，2021，38（20）：2790-2800.
[8]	高灵，郑忠涛，韩奖励，等.脑CT灌注成像在早期重型颅脑损伤患者中的应用[J].国际神经病学神经外科学杂志，2021，48（2）：149-153.
[9]	魏民，张恒柱，朱磊，等.CT灌注成像联合血清生化指标在重型颅脑损伤术后脑梗死诊断中的作用[J].中华神经外科杂志，2019，35（10）：1067-1069.
[10]	陈鹏军，林桂涵，卢陈英，等.低剂量双源CT颅脑灌注成像在超急性期脑梗死中的诊断价值[J].中华放射学杂志，2020，54（2）：112-118.
[11]	Ye J，Chen JY，Xu N，et al.Bilateral lung transplantation after caesarean section in pregnancy with severe pulmonary arterial hypertension：A case report[J].Medicine，2019，98（47）：e18109.
[12]	张明，魏剑波，黄志刚，等.CD64指数联合淀粉样蛋白A对重症颅脑外伤术后颅内感染诊断价值[J].中华医院感染学杂志，2021，31（15）：2313-2317.
[13]	符惠宏，张雪红，李旻，等.脑灌注成像技术联合CT血管造影对缺血性脑卒中患者的诊断及治疗计划制定的意义[J].中国医师进修杂志，2019，42（12）：1103-1107.
[14]	Kamitaki BK，Tu B，Reynolds AS，et al.Teaching NeuroImages：Acute stroke captured on EEG in the ICU：Visual and quantitative analysis[J].Neurology，2019，92（6）：e626-e627.
[15]	吴雯菁，姚柳，吴俊泉，等.多时相CTA联合CTP全脑灌注成像在缺血性脑卒中患者侧支循环影像学诊断中的应用价值[J].卒中与神经疾病，2020，27（1）：38-41，46.
[16]	董永尧，石祥飞，张宗胜，等.重型颅脑外伤患者应用改良标准外伤大骨瓣开颅术治疗的效果分析[J].中国医药科学，2021，11（22）：165-168.
[17]	隋斌.标准外伤大骨瓣减压术联合高压氧治疗重型颅脑损伤患者的临床效果[J].中国当代医药，2022，29（4）：111-114.
[19]	Ko SB，Kim TJ，Sohn CH.Focal hyperemia in Wernicke′s encephalopathy：a preliminary arterial spin labeling MRI study[J].Neuroradiology，2020，62（1）：105-108.
[20]	唐勇，王远军.CT脑灌注成像定量分析在急性脑梗死早期诊断及手术指导中的临床价值研究[J].中国CT和MRI杂志，2021，19（10）：16-17，86.
[21]	张洪伟，李爱民，刘希光，等.TCD监测联合ICG荧光造影及FLOW800在颈动脉内膜剥脱术中的应用价值分析[J].中华神经医学杂志，2019，18（10）：1006-1013.
[22]	陶奉明，刘爱连，刘静红，等.像素闪耀算法在提高低剂量全肝CT灌注“一站式”成像图像质量中的应用[J].临床放射学杂志，2019，38（5）：927-930.
[18]	李玉花，罗昕，于克文，等.ECT脑血流灌注显像、CT和MRI在难治性癫痫中的诊断价值分析[J].影像科学与光化学，2019，37（4）：378-384.