CTV Evaluation Of Intracranial Venous Circulatory Disturbance For The Patients With Acute Subdural Hematoma

Part 1: Reproduce the spatial conformation of subdural hematoma and intracranial vein based on CTV volume reconstruction and image fusion technologyObjective: Explore the application of craniocerebral Computed tomography venography(CTV)technology and its post-processing volume reconstruction,image fusion and curved surface reconstruction technology in patients with acute subdural hematoma(ASDH).Methods: Eight cases of the adult patients were included in Fuzhou Changle District Hospital and People’s Liberation Army Joint Service Support Force 900 Hospital from August 2018 to August 2019.They were clearly diagnosed as ASDH,and there were indications for subdural hematoma removal by craniotomy.Cranial CTV examination was performed before the operation and one week after the craniotomy.Import the data into the Advantage Window 4.6 workstation,and reconstruct the ASDH and intracranial veins through volume reconstruction technology to display the spatial conformation of the ASDH and adjacent veins.It also shows the method of measuring intracranial veins with curved surface reconstruction technology.Results: Applying the cranial CTV post-processing technology-volume reconstruction technology,reconstruct the fusion image of ASDH and adjacent veins,and then show the spatial structure relationship between the two and the morphological changes of intracranial veins,providing a method to accurately measure the volume of ASDH using volumetric method.The curved surface reconstruction technique is used to measure the cross-sectional area,length and diameter of intracranial veins,and compares the preoperative and postoperative changes of the parasagittal cortical veins with examples.Conclusion: The cranial CTV examination has the advantages of non-invasive and fast.Its volume reconstruction three-dimensional fusion technology and curved surface reconstruction technology can clearly display the fusion image of the intracranial vein and ASDH,and provide a reliable measurement method of the intracranial vein and ASDH.Venous circulation research provides reliable technical support.Part 2: Correlation between the MIP projection area of the superior sagittal cortical vein and the prognosis in patients with ASDHObjective:Using craniocerebral CTV and post-processing techniques to observe and measure the MIP projection area of the superior sagittal cortical vein,and explore its correlation with prognosis,in order to provide an important reference for the formulation of ASDH diagnosis and treatment plans.Methods: From August 2018 to August 2020,31 adult patients who were clearly diagnosed with ASDH from Changle District Hospital of Fuzhou City and the 90 th Hospital of the Joint Service Support Force of the People’s Liberation Army were included.All patients were required to undergo craniocerebral CTV examination before surgery.Import the data into the Advantage Window 4.6 workstation,apply the maximum intensity projection(MIP)reconstruction technology to reconstruct the parasagittal cortical vein,select the MIP image section centered on the interventricular foramen plane as the observation plane,and import the image into Image J software for processing Analysis,to observe the MIP projection area of the affected and unhealthy cortical veins,and the ratio of the MIP projection area of the affected and unhealthy cortical veins to assess the correlation between the above indicators and the prognosis.Results: Use MIP reconstruction technology to reconstruct the parasagittal cortical veins,select the MIP image section centered on the interventricular foramen plane as the observation plane,observe the MIP projection area of the affected side and the contralateral cortical vein,and the MIP projection of the affected side and the contralateral cortical vein Area ratio(β),statistics show that there is no correlation between the MIP projection area of the affected side or the contralateral cortical vein and the GOS score.The difference in β between the good prognosis group and the poor prognosis group was statistically significant(P<0.001).β is positively correlated with GOS score(r=0.945,P<0.001).Conclusion:After ASDH,the ratio of the MIP projection area(β value)of the affected side to the contralateral cortical vein can be used to predict the prognosis of the patient.When β is less than 1,the prognosis should be vigilant and provide a reference for formulating diagnosis and treatment plans.Part 3: Observation and analysis of delayed filling imaging of internal cerebral veins in ASDH patientsObjective:Using craniocerebral CTV and its post-processing technology to observe and measure the diameter of the internal cerebral veins and the displacement of the midpoint of the bilateral internal cerebral veins from the median sagittal plane,and to explore its correlation with the prognosis to guide diagnosis and treatment.Methods: From August 2018 to August 2020,31 adult patients who were clearly diagnosed with ASDH from Changle District Hospital of Fuzhou City and the 90 th Hospital of the Joint Service Support Force of the People’s Liberation Army were included.All patients were required to undergo craniocerebral CTV examination before surgery.Import the data into Advantage Window 4.6 workstation,apply MIP reconstruction technology to reconstruct the internal cerebral vein,select the MIP image section centered on the internal cerebral vein as the observation plane,import the image into Image J software for analysis,and observe the diameter of the bilateral internal cerebral veins and the displacement of the midpoint of the veins from the mid-sagittal plane to assess the correlation between the above indicators and prognosis.Results: Apply MIP technology to reconstruct the internal cerebral veins,select the MIP image section centered on the internal cerebral veins as the observation plane,observe the average of the diameters of the bilateral internal cerebral veins(D),and the deviation of the midpoint of the bilateral internal cerebral veins from the median sagittal plane Displacement(S).Statistics showed that the difference in D value between the good prognosis group and the poor prognosis group was statistically significant(P <0.01);the D value was positively correlated with the GOS score(r=0.862,P <0.001);the difference between the good prognosis group and the poor prognosis group The difference in S value was statistically significant(P < 0.01);S value was negatively correlated with GOS score(r=-0.809,P <0.001).Conclusion:After ASDH,the average diameter of the bilateral internal cerebral veins(D)and the displacement of the midpoint of the bilateral internal cerebral veins from the median sagittal plane(S)can be used to predict the prognosis of the patient and provide a reference for formulating diagnosis and treatment plans.