Early cerebral circulatory disturbance in patients suffering subarachnoid hemorrhage prior to the delayed cerebral vasospasm stage: xenon computed tomography and perfusion computed tomography study.
Early cerebral circulatory disturbance in patients suffering subarachnoid hemorrhage prior to the delayed cerebral vasospasm stage: xenon computed tomography and perfusion computed tomography study.
复制标题
迟发性脑血管痉挛阶段之前蛛网膜下腔出血患者的早期脑循环障碍：氙计算机断层扫描和灌注计算机断层扫描研究。
DOI：
10.2176/nmc.52.488
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发表时间：
2012
影响因子：
1.9
通讯作者：
T. Kishi
中科院分区：
文献类型：
--
作者：
Mitsuru Honda;S. Sase;K. Yokota;Ryo Ichibayashi;K. Yoshihara;Y. Sakata;Hiroyuki Masuda;Hiroyuki Uekusa;Y. Seiki;T. Kishi
蛛网膜下腔出血（SAH）会引起脑血流（CBF）的动态变化，并导致血管痉挛引起的迟发性缺血，以及迟发性脑血管痉挛（CVS）之前的早期灌注缺陷。本研究探讨了延迟CVS前早期脑循环障碍的严重程度，以及它是否可以用来预测患者的预后。共有94例SAH患者在第1-3天同时接受氙计算机断层扫描（CT）和灌注CT，以评价脑循环。采用氙气CT测量脑血流量（CBF），采用灌注CT测量平均通过时间（MTT），计算脑血容量（CBV）。采用格拉斯哥结局量表（恢复良好[GR]、中度残疾[MD]、重度残疾[SD]、植物人状态[VS]或死亡[D]）评价结局。Hunt和Hess（HH）II级患者的CBF显著高于HH IV和V级患者，MTT显著低于HH IV和V级患者。HH III级患者显示出比HH IV级和V级患者显著更高的CBF和更低的MTT。预后良好的患者（GR或MD）的CBF显著高于预后不良的患者（SD、VS或D），MTT显著低于预后不良的患者。这些参数的判别分析可以预测患者的结果，概率为74.5%。入院时HH分级越高，CBF和CBV越低，MTT越长。迟发性CVS发作前CBF降低和MTT延长可能影响SAH的临床预后。这些参数有助于评估SAH的严重程度和预测SAH患者的预后。
Subarachnoid hemorrhage (SAH) causes dynamic changes in cerebral blood flow (CBF), and results in delayed ischemia due to vasospasm, and early perfusion deficits before delayed cerebral vasospasm (CVS). The present study examined the severity of cerebral circulatory disturbance during the early phase before delayed CVS and whether it can be used to predict patient outcome. A total of 94 patients with SAH underwent simultaneous xenon computed tomography (CT) and perfusion CT to evaluate cerebral circulation on Days 1-3. Cerebral blood flow (CBF) was measured using xenon CT and the mean transit time (MTT) using perfusion CT and calculated cerebral blood volume (CBV). Outcome was evaluated with the Glasgow Outcome Scale (good recovery [GR], moderate disability [MD], severe disability [SD], vegetative state [VS], or death [D]). Hunt and Hess (HH) grade II patients displayed significantly higher CBF and lower MTT than HH grade IV and V patients. HH grade III patients displayed significantly higher CBF and lower MTT than HH grade IV and V patients. Patients with favorable outcome (GR or MD) had significantly higher CBF and lower MTT than those with unfavorable outcome (SD, VS, or D). Discriminant analysis of these parameters could predict patient outcome with a probability of 74.5%. Higher HH grade on admission was associated with decreased CBF and CBV and prolonged MTT. CBF reduction and MTT prolongation before the onset of delayed CVS might influence the clinical outcome of SAH. These parameters are helpful for evaluating the severity of SAH and predicting the outcomes of SAH patients.
一种使用计算机断层扫描定量局部脑血容量测量的新方法。
影响因子：
8.3
作者：
Muizelaar,JP;Fatouros,PP;Schröder,ML
通讯作者：
Schröder,ML