脑出血早期血肿扩大机制的CT densitometry研究

项目名称： 脑出血早期血肿扩大机制的CT densitometry研究

项目编号： No.81200899

项目类型： 青年科学基金项目

立项/批准年度： 2013

项目学科： 神经系统疾病、精神疾病

项目作者： 李琦

作者单位： 重庆医科大学

项目金额： 23万元

中文摘要： 脑出血患者中有超过三分之一的患者出现早期血肿扩大。研究表明早期血肿扩大是造成脑出血患者神经功能恶化的重要原因。血肿扩大可导致患者神经功能缺失加重和预后不良。目前脑出血早期血肿扩大的机制还不清楚，也没有有效地治疗方法。目前多数学者认为脑出血早期血肿扩大是由于持续出血或再出血所致。有研究表明，血肿高渗状态和血肿周围水分子的进入也有可能导致血肿扩大。如果血肿扩大是继续出血所致，第二次血肿的平均密度与第一次血肿相比，平均密度不变或有轻度增加。如果由于血肿稀释所致血肿扩大，血肿平均密度将降低。本研究通过对脑出血患者6小时内及24小时行CT扫描，通过自主研发Matlab编程进行CT图像的配准，由Analyze软件精确测量血肿体积变化和血肿密度的动态变化，从而为阐明脑出血早期血肿扩大的机制奠定基础，为脑出血的治疗提供新的靶点。

中文关键词： 脑出血；早期血肿扩大；血流动力学；影像；预测因素

英文摘要： Intracerebral hemorrhage is a devastating neurological disorder that accounts for 20-30% of stroke in China. Early hematoma enlargement which is defined as hematoma expnasion of greater than 30% on the 24 hour follow-up CT scan, was seen in approximately one third of patients with intracerebral hemorrhage. Previous research suggested that early hematoma enlargement is an important cause of neurological deterioration and poor functional outcome in patients with intracerebral hemorrhage. It is an independent predictor of poor functional outcome at 3 months. The exact mechanism of early hematoma enlargement is unclear. There is no effective treatment after intracerebral hemorrhage. There is no perfect animal models that could accurately similate the intracerebral hemorrhage pathophysiology. Current understanding of mechanisms of hematoma enlargement are mainly based on neuroimaging research of patients with intracerebral hemorrhage. The most accepted mechanism for hematoma enlargement was continued bleeding or rebleeding. Recent research suggested that osmotic pressue induced dilution of hematoma may also contribute to hematoma enlargement. Rebleeding or continued bleeding may lead to increased or unchanged mean CT density within the hematoma. In contrast, osmotic pressure induced hematoma dilation may lead to decr

英文关键词： intracerebral hemorrhage；early hematoma expansion；hemodynamics；imaging；predictor