转化医学杂志2026，Vol.15Issue(3)：393-397,5.DOI:10.3639/j.issn.2095-3097.2026.03.006
基于CT灌注成像参数量化评估颅脑损伤患者早期损伤严重程度的价值研究
A Study on the Value of Quantitative Assessment of Early Injury Severity in Patients with Traumatic Brain Injury Based on CT Perfusion Imaging Parameters
摘要
Abstract
Objective To evaluate the value of quantitative assessment of early injury severity in patients with traumatic brain injury(TBI)based on computed tomography perfusion imaging(CTPI)parameters.Methods A total of 220 patients with TBI admitted to the Fourth People's Hospital of Hengshui from January 2019 to December 2022 were retrospectively enrolled.All patients underwent CT and CTPI upon admission,and were divided into a mild-to-moderate group[Glasgow Coma Scale(GCS)score:9-15,n=138]and a severe group(GCS score:≤8,n=82)according to their admission GCS scores.The CTPI parameters of the hemorrhagic core area of the lesion,perilesional hypodense area and contralateral mirror area were compared between the two groups.Multivariate Logistic regression analysis was performed to identify the influencing factors of early injury severity in TBI patients;a predictive model for early injury severity in TBI patients was constructed,and the receiver operating characteristic(ROC)curve was used to analyze the predictive value of this model.Results In both groups,the cerebral blood volume(CBV)and cerebral blood flow(CBF)in the hemorrhagic core area were lower than those in the perilesional hypodense area and contralateral mirror area,and the CBV and CBF in the perilesional hypodense area were lower than those in the contralateral mirror area(P<0.05).The mean transit time(MTT)in the hemorrhagic core area was longer than that in the perilesional hypodense area and contralateral mirror area,and the MTT in the perilesional hypodense area was longer than that in the contralateral mirror area(P<0.05).Compared with the mild-to-moderate group,the severe group had lower CBV and CBF and longer MTT in the hemorrhagic core area and perilesional hypodense area(P<0.05).Multivariate Logistic regression analysis showed that higher CBV and CBF in both the hemorrhagic core area and perilesional hypodense area,as well as a higher GCS score,were independent protective factors for early injury severity in TBI patients.In contrast,prolonged MTT in both the hemorrhagic core area and perilesional hypodense area were independent risk factors for early injury severity in TBI patients(OR=0.592,95%CI:0.429-0.783,P=0.008;OR=0.826,95%CI:0.608-0.955,P=0.038;OR=0.616,95%CI:0.427-0.806,P=0.009;OR=0.842,95%CI:0.507-0.895,P=0.041;OR=0.848,95%CI:0.686-0.963,P=0.009;OR=2.007,95%CI:1.615-3.790,P=0.004;OR=1.487,95%CI:1.273-1.890,P=0.038).ROC curve analysis indicated that the area under the curve of the predictive model for evaluating early injury severity in TBI patients was 0.795(95%CI:0.684-0.853),with a sensitivity of 0.753 and a specificity of 0.775.Conclusion The quantitative model based on CTPI parameters has a high value in predicting the severity of early injury in TBI patients.关键词
CT灌注成像参数/颅脑损伤/损伤程度Key words
computed tomography perfusion imaging/traumatic brain injury/injury severity引用本文复制引用
吴婷,史佩佩,王芬,吴淅铭,陈祥云..基于CT灌注成像参数量化评估颅脑损伤患者早期损伤严重程度的价值研究[J].转化医学杂志,2026,15(3):393-397,5.基金项目
衡水市科技计划项目(2022014002Z) （2022014002Z）
