自发性脑出血急性期血肿变化情况是影响患者预后的主要因素。研究证实急性期血肿内血管损伤是影响血肿变化的关键因素，但是血肿与血管损伤之间的演变过程和规律目前尚不清楚。课题组前期基于能谱CT设计了多期相CTA扫描技术，研究急性期血肿增长，发现急性期血肿内强化灶的对比剂渗漏量，这一现象不但能够准确反映血肿内血管损伤，还可以区分血管损伤类型，但这些表现特点与血肿变化之间的关系尚待阐明。基于此，本课题组拟应用能谱多期相CTA扫描技术，根据强化灶出现的时相，确定血肿内血管损伤类型，通过碘基定量评价不同血管损伤类型和损伤程度之间的差异；通过血标本的动态变化，分析不同血管损伤类型和血清标志物表达之间的关系；结合24h后CT复查结果，研究不同血管损伤类型之血肿的变化特点，揭示脑出血急性期之血肿和血管损伤之间的演变规律，为临床制定个性化治疗方案提供理论依据。

The hematoma expansion is the most important risk factors of poor outcomes in spontaneous intracerebral hemorrhage (SICH) patients. The hematoma progressively enlarges due to the rupture of micro-vessels inside the hematoma,but the relationship between the vessel damage and the variation of the hematoma is still undefined.Recently on the basis of multi-phase spectral CT, we found that the iodine concentration in the enhanced focus could independently reflect the rupture of micro-vessels. The multi-phase CTA can also distinguish the type of the damaged vessels and examine the dynamic change of the iodine concentration. In this research, we apply multi-phase CTA technology to determine the different type of vascular injury in hematoma through appearance time of the enhanced focus. The iodine concentration was used to evaluate the degree of different types of vascular injury. The dynamic changes of blood samples were used to evaluate the differences in the expression of serum markers in different types of vascular injury. Combined with the 24 h CT follow-up, the characteristics of hematoma changes in different types of vascular injury are studied to reveal the changes of hematoma in the acute phase of cerebral hemorrhage, which can provide a theoretical basis for the clinical development of personalized treatment.