目的 探讨320排CT 4D-CTA联合 全脑灌注CTP技术在脑膜瘤术前评估中的 价值及优势。方法 对拟诊为脑膜瘤的9例 患者采用320排CT全脑灌注容积扫描一站 式检查，一次扫描可获得平扫、多期增强 图像，经后处理得到CTP图像、血管与灌 注融合图像，经过切割方法进行数据信息 提取和重建，然后模拟瘤体实体大小，提 取瘤体并与血管融合。观察并评价脑膜瘤 大小、形态，瘤体血流灌注情况及其与邻 近血管关系，利用后处理图像为外科手术 制定手术预案。结果 共9例患者成功完成 全脑灌注容积扫描；3D-CTP图像可以显示 肿瘤异常灌注区。脑膜瘤和正常脑组织之 间CBF和CBV存在显著差异。4D-CTA显示了 脑膜瘤的供血和引流静脉。共6例患者成 功实施手术，其中纤维型脑膜瘤4例，上 皮细胞型脑膜瘤2例；余3例患者未进行手 术。结论 4D-CTA联合CTP技术可以准确反 映脑膜瘤血供情况，为完善手术方案、指 导手术提供重要依据，对肿瘤的精准切 除、减少术中出血及损伤有较大的指导意 义。

Objective To investigate the value and advantages of 4D-CTA combined with whole brain perfusion CTP technique by 320 row CT in preoperative evaluation of meningiomas adjacent to large vessels. Methods A total of 9 patients with suspected meningioma were examined by 320 row CT in whole brain perfusion volume scanning. Plain scan and multi-phase enhanced images can be obtained by one scan. By postprocessing, CTP images, blood vessels and perfusion or fusion images were obtained. After cutting, data information was extracted and reconstructed, then the size of tumor is simulated, and the tumor is extracted and fused with blood vessel. The size and shape of meningioma, the blood perfusion and its relation with adjacent vessels were observed and evaluated. Surgical plans were made for the surgeons by post-processing images. Results A total of 9 patients accepted the whole brain perfusion volume scan successfully. Abnormal perfusion areas were identified on 3D-CTP maps. Significant differences in CBF and CBV were detected between meningioma and normal brain tissues. The blood supplying and draining veins of the tumor could be observed on 4D-CTA images in 9 cases, and 6 patients underwent successful surgery, including 4 cases of fibrous meningioma and 2 cases of epithelial meningioma, while the other 3 patients had not undergone surgery. Conclusion 4D-CTA combined with CTP technology can reflect the meningioma blood supply accurately, can guide the surgeon to improve the operation plan effectively, which has great guiding significance for accurate resection of tumors and reduce intraoperative bleeding and injury.