《中国康复理论与实践》

《中国康复理论与实践》 ›› 2004, Vol. 10 ›› Issue (08): 472-474.

• 基础研究 • 上一篇    下一篇

实验性脑出血周围组织局部脑血流变化的CT灌注成像

周剑1,3; 高培毅1; 李小光1; 万虹2   

  1. 1.北京市神经外科研究所神经影像中心 北京市 100050;2.北京市神经外科研究所神经干细胞室 北京市 100050;3.武警总医院磁共振室 北京市 100050
  • 收稿日期:2004-05-17 出版日期:2004-08-25 发布日期:2004-08-25

CT perfusion imaging study of perihematomal cerebral blood flow in experimental intracerebral hemorrhage

ZHOU Jian, GAO Pei-yi, LI Xiao-guang, et al   

  1. Neuroimaging Center, Beijing Neurosurgical Institute, Beijing 100050, China
  • Received:2004-05-17 Published:2004-08-25 Online:2004-08-25

PDF (PC)

被引次数

12

摘要： 目的探讨急性期大鼠脑血肿周围组织局部脑血流变化机制。方法健康成年雄性SD大鼠70只,随机分为注血组和对照组,每组分为注血(或注射)后1h、3h、6h、12h、24h、48h及72h 7个实验小组,分别将40μl新鲜自体血或生理盐水通过微量注射泵注入大鼠脑右侧尾状核制备脑出血模型。利用CT灌注成像对大鼠进行动态增强扫描,通过计算机辅助脑灌注成像软件制作大鼠脑CT灌注参数图,并对血肿周围局部脑血流量(rCBF)、局部脑血容量(rCBV)和对比剂平均通过时间(MTT)进行测定。结果注血组血肿周围脑组织存在不同程度低灌注 ,低灌注梯度依色阶变化表现为多层彩色环绕带,呈“靶样”改变。血肿边缘区rCBF和rCBV显著低于血肿外层区;血肿周围局部脑血流量呈波动性改变,注血后1hrCBF降至最低,其后逐渐回升并再次下降;血肿周围rCBV在注血后1h最低,以后逐渐增加,并于注血后24h增加至峰值。结论脑出血发生后血肿周围局部脑血液动力学发生异常改变,血肿占位效应及其所致的颅内压增高,以及脑血流最初下降所促发的脑血流自身调节,在血肿周围脑血流变化中发挥着重要作用。

关键词: 脑出血, 脑血流, 体层摄影术, 灌注成像

Abstract: ObjectiveTo study the mechanism of hemodynamic alternation surrounding the hematoma in the acute stage of intracerebral hemorrhage (ICH) in rats.MethodsSeventy male Sprague Dawley rats were randomly divided into ICH group and sham operated group, which were microinjected with 40 μl fresh autologous blood or saline into the right caudatum respectively. The each group was divided into 7 subgroups at 1h,3h,6h,12h,24h,48h and 72h after the ICH. CT perfusion imaging in measurements of regional cerebral blood flow adjacent to hematomas was performed. The ratios of side to side were measured at the regions around the hematomas by personal computer aided mapping. So the parameters of regional cerebral blood flow(rCBF), regional cerebral blood volume(rCBV) and mean transit time(MTT) were calculated respectively.ResultsThe rCBF and rCBV adjacent to the hematomas were lower than those of the outer region pronouncedly. The alternation of rCBF around the hematoma were fluctuated, which reduced to the valley at 1h after ICH, and then gradually returned to the peaks at 6h and 24h after ICH. In the meantime, the rCBV around the hematoma reduced to the valley at 1h after ICH, and then gradually increased to the peak at 24h after ICH.ConclusionThe abnormal hemodynamic changes can be found in the perihematomal region after ICH. The alternation of rCBF around the hematomas are fluctuated, but the changes of rCBV remain continuous increase. The mass effect of hematoma, intracranial hypertension caused by the mass effect of hematoma, and the autoregulation of cerebral blood flow motivated by the initial depression of cerebral blood flow play a very important role in the changes of cerebral blood flow.

Key words: intracerebral hemorrhage, cerebral blood flow, computed tomography, perfusion imaging