目的通过螺旋CT灌注成像(CTP)检测局部脑血流参数,探讨其在中、重度颅脑损伤中的相关性,对比研究其变化规律。方法根据格拉斯哥昏迷量表(GCS)评分选择32例中型和重型颅脑损伤患者进行CTP检查,检测局部脑血流量(r CBF)、局部脑血容积(r CBV)、血液通过组织的平均通过时间(MTT),分析三者间的相关性及其与颅脑损伤程度的关系。结果患者脑组织损伤部位的r CBV和r CBF明显低于对侧,MTT显著高于对侧(均P<0.05);重型组r CBF和r CBV明显低于中型组(均P<0.05)。手术组患者术前与术后第3 d对比,患侧r CBV明显高于术前,而术后MTT则显著低于术前(均P<0.05);中、重型颅脑损伤患者创伤部位的r CBV与格拉斯哥预后量表(GOS)评分呈正相关,而MTT、r CBF与GOS评分无相关性。结论通过CTP检测患者损伤部位的r CBF、r CBV和MTT可判断脑损伤的程度和预后,对指导临床医师治疗有着重要的意义。 Objective To detect the regional cerebral blood flow parameters by spiral CT perfusion imaging (CTP), and to explore its correlation with moderate and severe traumatic brain injury. Methods According to the Glasgow Coma Scale (GCS), 32 patients with moderate and severe craniocerebral injury were selected for CTP examination. The regional cerebral blood flow (r CBF), regional cerebral blood volume (r CBV), mean passage time of blood through the tissue (MTT), analyze the correlation between the three and its relationship with the degree of brain injury. Results The r CBV and r CBF in the lesioned brain tissue were significantly lower than those in the contralateral and the MTT were significantly higher than those in the contralateral (all P <0.05). The levels of r CBF and r CBV in the severe group were significantly lower than those in the medium group (all P <0.05). The r CBV in the operation group was significantly higher than that before operation and the postoperative MTT was significantly lower than that before operation (all P <0.05). There was no significant difference between the operation group and the control group r CBV and Glasgow Outcome Scale (GOS) score was positively correlated, while MTT, r CBF and GOS score no correlation. Conclusion The detection of r CBF, r CBV and MTT in patients with CTP can determine the degree and prognosis of brain injury, which is of great significance to guide the clinicians in the treatment.