目的 探讨脑CT灌注成像技术对轻型颅脑损伤(mTBI)患者预后的评估价值。方法 收集2020-01至2022-01联勤保障部队第908医院轻型颅脑损伤患者34例,行头颅64排CT平扫及脑CT灌注成像检查,脑创伤后1个月对患者进行随访及Rivermead脑震荡症状问卷评分(RPQ)作为预后评估指标。结果 30例(88.2%)发现脑灌注异常,12例(35.3%)出现脑震荡后综合征(PCS)阳性(RPQ＞14分),4例(11.8%)未见异常灌注改变。30例灌注异常患者中PCS阳性11例(36.7%),4例无灌注异常患者PCS阳性中仅1例(25.0%)。灌注异常区域主要表现为额叶或颞叶局灶性低灌注改变。结论 脑CT灌注成像有助于了解mTBI患者血流动力学变化情况,对评价病情严重程度,及时纠正脑微循环异常具有重要意义。
Abstract
Objective To evaluate the value of CT cerebral perfusion imaging in the prognosis of patients with mild traumatic brain injury (mTBI). Methods A total of 34 patients with mTBI collected in the 908th Hospital of PLA Joint Logistics Support Force who underwent CT plain scan and perfusion imaging examination were reviewed one month after TBI using Rivermead post-concussion symptoms questionnaire (RPQ) scores as prognostic indicators. Results Abnormal cerebral perfusion was found in 30 cases (88.2%).Post-concussion syndrome(PCS) was positive in 12 cases(35.3%) (RPQ score>14). No abnormal perfusion changes were observed in 4 patients(11.8%). Of the 30 patients with abnormal perfusion, 11cases (36.7%) showed PCS, while only 1(25%) of the 4 patients without abnormal perfusion were PCS positive. The areas with abnormal perfusion were mainly manifested as focal hypoperfusion in the frontal and temporal lobes. Conclusions The hemodynamic changes in patients with mTBI canbe assessed by CT cerebral perfusion imaging, which may further help to guide the evaluation of disease severity and timely treatment of the abnormal cerebral microcirculation, thus improving the prognosis of mTBI.
关键词
CT灌注成像 /
轻型颅脑损伤 /
脑震荡后综合征
Key words
CT perfusion imaging /
mild traumatic brain injury /
post-concussion syndrome
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基金
江西省卫健委科技计划课题(202131122)
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