【摘要】 目的采用320层CT灌注成像探讨窦旁脑膜瘤瘤周水肿产生机制。方法 45例窦旁脑膜瘤患者根据MRI检查T2相表现,分为二组:A组29例,肿瘤周围有不同程度水肿表现;B组16例,无瘤周水肿。术前行320层CT检查,将容积数据导入Toshiba公司的4D～灌注专门软件包进行后处理。得出灌注图像及参数,包括脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)和达峰时间(TTP)。结果二组瘤组织CBF、CBV、MTT无明显差别(P>0.05),肿瘤组织的TTP:A组(13.8±1.4)s、B组(19.1±2.4)s,二组相差显著(P<0.01)。瘤周脑组织TTP:A组(0.5 cm、1.5 cm):(27.7±3.6)s、(24.1±3.2)s,B组:(14.8±1.3)s二组间有显著差别(P<0.01)。灌注成像与CTA图像融合能清晰显示供血动脉、肿瘤组织、脑组织、引流静脉以及与窦的关系,A组可见肿瘤引流静脉迂曲、引流不畅。结论 320层CT灌注成像对窦旁脑膜瘤血流灌注的定量研究提供了新的方法,肿瘤组织TTP延长可能是产生瘤周水肿的重要因素。更多还原

【Abstract】 Objective To investigate the mechanism of peritumoral brain edema(PTBE) in parasagittal meningiomas by 320 row CT perfusion imaging.Methods A total of 45 cases with parasagittal meningiomas were divided into 2 groups according T2-weighted MRI: 29 cases(group A) with peritumoral brain edema in different degree and 16 cases(group B) without PTBE.All cases were examined by 320 row CT before operation.The scanning images were calculated by 4D perfusion software in workstation to get perfusion images and data,including cerebral blood flow(CBF),cerebral blood volume(CBV),mean transit time(MTT) and time to peak(TTP).Results There was no significant difference in CBF,CBV,and MTT of tumor tissues between two groups(P>0.05).TTP of tumor tissues in group A(13.8 s±1.4 s) was significant higher than that of group B(19.1 s±2.4 s)(P<0.01).In peritumoral brain tissues,there was significant difference in TTP between two groups.The fusion of perfusion imaging and CTA could clearly provide the images of parent artery,tumor tissues,brain tissues,drainage veins and sagittal sinus.Conclusion 320 row CT perfusion imaging may provide a new method for the quantitative research of parasagittal meningioma.The prolonging TTP of tumor tissues may play an important role in the progression of PTBE.更多还原