Study on hemodynamics of high altitude polycythemia by 3D-ASL combined with CT cerebral perfusion

Objective To investigate the changes of CT cerebral perfusion (CTP) and the application value of nuclear magnetic resonance proton spin labeling (3D-ASL) and to conduct a comparative study. Methods Multi-slice spiral CT(MDCT) was used to study the changes of CTP in 22 patients with HAPC. Comparison of CT whole-brain perfusion technique and nuclear magnetic resonance proton spin labeling technique (3D-ASL) in hemodynamic changes of the brain in plateau polycythemia. Results With the aggravation of HAPC, CBF of cerebral cortex and white matter showed a downward trend. Except the white matter of frontal lobe and temporal lobe, the difference of HAPC among different diseases was statistically significant ( P < 0.05). Along with the aggravation of, each part of the brain cortex and white matter CBV increase, white matter, and each part CBV difference had statistical significance between different condition ( P < 0.05). With the aggravation of the disease, the MTT of cortex and white matter in all parts of the brain increased significantly, and the difference of MTT between different parts of the disease was statistically significant ( P < 0.05). HAPC patients along with the aggravation of different level, rCBF is reduced, in addition to the parietal cortex, temporal and occipital white matter, white matter rCBF differences between different parts of different condition have statistical significance ( P < 0.05). ROC curve was used to evaluate the diagnostic value of CTP and ASL. The two curves were close to each other, and CTP was slightly better than ASL. Conclusion With the progression of HAPC, cerebral blood flow decreased, blood volume increased, and average blood flow time prolonged in patients with different degrees of HAPC. CTP and ASL had similar effects, and the former had slightly better value. 摘要： 目的 研宄高原红细胞增多症(HAPC)CT脑灌注 (CTP) 的变化/核磁共振质子自旋标记技术 (3D-ASL) 的应用 价值并进行对比研宄。 方法 用多层螺旋 CT(MDCT) 研宄 22 例不同程度高原红细胞增多症患者的 CT 脑灌注的变 化; CT 全脑灌注技术与核磁共振质子自旋标记技术 (3D-ASL) 在高原红细胞增多症脑部血流动力学改变中的应用价 值的比较。 结果 HAPC 随病情加重, 大脑皮质和白质均脑血流量 (CBF) 呈下降趋势, 除额叶白质和颞叶白质外, 余部 位不同病情间差异均有统计学意义 ( P < 0.05); 随病情加重, 大脑各部位皮质和白质脑血容量 (CBV) 增加, 白质更为显 著, 且各部位不同病情间 CBV 差异均有统计学意义 ( P < 0.05); 随病情加重, 大脑各部位皮质和白质平均通过时间 (MTT) 均显著增加, 各部位不同病情间 MTT 差异均有统计学意义 ( P < 0.05); 不同程度 HAPC 患者随病情加重 ( P <0.05), 相对脑血流量(rCBF)降低, 除顶叶皮质、颞叶白质和枕叶白质外, 各部位不同病情间rCBF差异均有统计学意 义;通过 ROC 曲线来评价 CTP 和ASL两者的诊断价值, 两条曲线接近, CTP 略优于 ASL。 结论 不同程度HAPC患 者随着病情进展, 脑血流减低;血容量增加;血流平均通过时间延长; CTP 与 ASL 两种方法效果接近, 前者价值略优。