Application Of Whole-brain CT Perfusion Imaging In The Evaluation Of Patients With Disorder Of Consciousness

Objective:The cerebral blood flow reserve and cerebral perfusion in patients with chronic disorder of consciousness were evaluated by Computed tomography perfusion(CTP),and the correlation between cerebral blood perfusion and disturbance of consciousness was explored,and the degree of disturbance of consciousness in patients with coma was evaluated for the early clinical stage.and provide a reliable basis for predicting prognosis.Methods:Seventy-four patients with consciousness disorder who were hospitalized in the Department of Rehabilitation Medicine of the First Affiliated Hospital of Nanchang University from March 2021 to September 2021 were selected as the subjects.GCS,CRS-R and other behavioral assessments were performed within 7 days after admission.They were divided into VS group and MCS group according to CRS-R scale.The whole brain CT perfusion imaging was performed on the same day,cerebral blood flow(CBF),cerebral blood volume(CBV),mean transfer time(MTT)and time to peak(TTP)in different parts of the two groups were recorded.The characteristics of cerebral blood perfusion in different parts of the two groups were analyzed,and the correlation between CTP parameter values and GCS scale and GOS scale was analyzed statistically.Results:1.CBF values of bilateral basal ganglia,frontal lobe,temporal lobe,occipital lobe,affected area and brain stem in VS group were lower than those in MCS group,CBV values of other brain areas in VS group were lower than those in MCS group except bilateral frontal lobe and occipital lobe,MTT values of healthy basal ganglia,healthy temporal lobe,healthy occipital lobe,affected area and brain stem in VS group were higher than those in MCS group.The TTP values of basal ganglia,affected area and brainstem in VS group were higher than those in MCS group,and the difference was statistically significant(P < 0.05).2.CBF values in all ROI regions were positively correlated with GCS and CRSR scores(P < 0.05).The CBV values of all ROI regions were positively correlated with GCS score(P < 0.05),and the CBV values of bilateral basal ganglia,affected frontal lobe,bilateral temporal lobe and brainstem were positively correlated with CRS-R score.The MTT values of bilateral frontal lobe,affected temporal lobe,affected occipital lobe,affected area and brain stem were negatively correlated with GCS score,while the MTT values of bilateral basal ganglia,healthy frontal lobe,bilateral temporal lobe,affected occipital lobe,affected area and brain stem were negatively correlated with CRS-R score.MTT values of all ROI regions were negatively correlated with GCS and CRS-R scores,and the differences were statistically significant(P < 0.05).3.Correlation analysis was conducted between the mean value of parameters of healthy and affected sides and GOSE score.The results showed that CBF and CBV of basal ganglia,frontal lobe,temporal lobe,affected area and brainstem were positively correlated with GOSE score,while MTT and TTP were negatively correlated with GOSE score.Conclusion:Cerebral blood perfusion was decreased in patients with different degrees of consciousness impairment,and it was further decreased with the deepening of the degree of consciousness impairment.Cerebral CT perfusion parameters can provide reference for early clinical evaluation of the degree of disturbance of consciousness and prognosis of coma patients to a certain extent.