Study On Hemodynamics Of High Altitude Polycythemia By 3D-ASL Combined With CTP

Objective:Using CT perfusion technology to study the changes of hemodynamics of brain in different degree of high altitude polycythemia(HAPC).To evaluate the value of arterial spin labeling and CT perfusion(CTP)imaging in HAPC.Methods:Select the patients who had been diagnosed with HAPC,and divided into three groups of mild,moderate and severe according to the severity,8 cases in mild group,7 cases in moderat and 7cases in severity group.10 cases in normal control group which were normal adults at high altitude.Each of them underwent MR and CT examination of head by using SIEMENS 3.0T MRl scanner and GE Revolution CT.Including conventional CTP sequences and ASL sequences.Selected the right and left mirror locations in frontal white ? grey matter,temporal white ? grey matter,occipital white ?grey matter,parietal white ?grey matter,thalamus and basal ganglia as the ROI in all graphs.The parameter valuess of each region of interest was measured and analyzed the same region of interest in each group.CBF and rCBF sequences were drawn in ROC curve to evaluate the value of both inspection methods.Results:1 Frontal grey matter:CBF comparison results:There was no difference between light and moderate and control group,and reduction in heavy group compared with normal control group.CBV and MTT comparison results:There was no difference between mild and moderate and control group,and Longer than normal group in severe group.rCBF comparison results:There was no difference between light and moderate and control group.Compared with normal and mild group,severe group is reduced(P<0.05).2 Temporal grey matter:CBF comparison results:No significant differences between groups.CBV and MTT comparison results:There was no difference between light and control group,and Longer than normal group in moderate and severe group,Longer than light group in severe group(P < 0.05).rCBF comparison results:There was no difference between light and moderate and control group,and reduction in heavy group compared with normal control group(P<0.05).3 Occipital grey matter:CBF comparison results:There was no difference between light and moderate and control group,and reduction in heavy group compared with normal control group.CBV and MTT comparison results: There was no difference between light and control group,Longer than control group in severe group(P<0.05).rCBF comparison results:There was no difference between light and moderate and control group,and reduction in heavy group compared with normal control group(P<0.05).4 Parietal grey matter : CBF comparison results:No significant differences between light and control group.and reduction in moderate and heavy group compared with normal control group.CBV and MTT comparison results:No significant differences between light and control group,and Longer than normal group in moderate and severe group(P< 0.05).rCBF comparison results:No significant differences between groups.5 Basal ganglia:CBF comparison results:Mild,moderate and severe groups all decreased compared with normal group(P < 0.05).CBV and MTT comparison results:The mild group was less than the normal control group.rCBF comparison results: Less mild group than normal control group,and there was no obvious abnormality in the moderate and severe group.6 Thalamus:CBF comparison results:No significant differences between groups.CBV and MTT comparison results:No significant differences between light and control group and Longer than mild group in moderate and severe group(P<0.05).rCBF comparison results:There was no significant difference between mild and moderate group and normal groups.Reduction in severe group compared to normal group(P<0.05).7 Frontal white matter:CBF comparison results:No significant differences between groups.CBV and MTT comparison results:No significant differences between light and control group,and Longer than control group in moderate and severe group,Longer than mild group in severe group(P<0.05).rCBF comparison results:There was no significant difference between mild and moderate group and normal groups.Reduction in severe group compared to normal group(P<0.05).8 temporal white matter:CBF comparison results:CBF comparison results:No significant differences between groups.CBV and MTT comparison results:There was no significant difference between mild group and normal group.Prolonged in middle and severe group compared with normal control group and Length of severe group over mild group(P<0.05).rCBF comparison results:No significant differences between groups.9 occipital white matter:CBF comparison results:No significant differences between mild and moderate and control group,and reduction in heavy group compared with moderate control group.CBV and MTT comparison results:There was no significant difference between mild group and normal control group,and reduction in severe group compared than control group in severe group(P < 0.05).rCBF comparison results:There was no difference between light and moderate and control group,and reduction in heavy group compared with normal control group(P<0.05).10 Parietal white matter:CBF comparison results:No significant differences between mild and control group.Reduction in moderate and severe group compared with normal control group.CBV and MTT comparison results:No significant differences between mild and control group.Prolonged in moderate and severe group compared with normal control group.MTT:Length of severe group over light group.CBV and MTT comparison results:No significant differences between mild and control group.Reduced than normal group in severe group(P<0.05).11 The areas comparison result of CBF and rCBF under curve :The area of CBF is bigger than rCBF(P<0.05).Conclusions:1 Compared to normal adults at high altitude,the perfusion parameters of partial regionals is small.2 With the progression of HAPC,the locations of Affected brain tissues were gradual expansion.3 Both CTP and ASL can found the changes in brain perfusion.CTP is more valuable by comparison.