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目的探讨动态增强磁化率(DSC)MR灌注成像对兔脑急性一氧化碳(CO)中毒脑微循环的变化规律并尝试其预测CO中毒迟发性脑病发生的可能性。材料与方法获得静态吸入法CO染毒前和染毒后1 h、3 d、5 d、7 d的5个时间点兔脑29只,根据临床出现迟发性脑病症状分未出现组(21只)和出现组(8只)。在海马层面放置感兴趣区(ROI)测量5个脑血流动力学参数:脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)、峰值时间(TTP)和信号强度恢复率(PSR)。用t检验比较两组间差异。结果染毒前和染毒后1 h、3 d、5 d CBV、CBF、MTT、TTP和PSR值两组之间差异均无统计学意义(P>0.05)。染毒后7 d CBV、CBF、MTT、TTP和PSR值两组间差异均有统计学意义(P<0.05)。第7 d灌注值对迟发性脑病有预测价值,CBV敏感性、特异性和准确性分别为100%、85.71%、89.66%;CBF敏感性、特异性和准确性分别为100%、61.90%、72.41%;MTT敏感性、特异性和准确性分别为25.00%、100%、79.31%;TTP敏感性、特异性和准确性分别为12.50%、100%、75.86%;PSR敏感性、特异性和准确性分别为100%、95.24%、96.55%。结论第7 d CBV和PSR值是预测CO中毒迟发性脑病发生的敏感因子。
Objective To investigate the changes of brain microcirculation induced by acute carbon monoxide poisoning (CO) in brain of dynamic enhanced magnetic resonance (MR) MR perfusion imaging and to explore the possibility of predicting delayed encephalopathy in CO poisoning. MATERIAL AND METHODS: 29 rabbits were killed at 5 time points before and 3 h, 3 d, 5 d and 7 d after CO exposure. According to the clinical symptoms of delayed encephalopathy, 21 Only) and appeared group (8). Five regions of interest (ROI) were placed in the hippocampus to measure hemodynamic variables: CBV, CBF, MTT, TTP and signal intensity Rate (PSR). T test was used to compare the differences between the two groups. Results There were no significant differences in CBV, CBF, MTT, TTP and PSR between the two groups before exposure and at 1, 3 and 5 d after exposure (P> 0.05). The differences of CBV, CBF, MTT, TTP and PSR between the two groups after 7 days exposure were statistically significant (P <0.05). The 7th day perfusion value had predictive value for delayed encephalopathy. The sensitivity, specificity and accuracy of CBV were 100%, 85.71% and 89.66% respectively. The sensitivity, specificity and accuracy of CBF were 100%, 61.90% , 72.41% respectively. The sensitivity, specificity and accuracy of MTT were 25.00%, 100% and 79.31%, respectively. The sensitivity, specificity and accuracy of TTP were 12.50%, 100% and 75.86% And the accuracy is 100%, 95.24%, 96.55% respectively. Conclusions CBV and PSR at day 7 are the sensitive predictors of delayed encephalopathy after CO poisoning.