目的 以CT增强扫描对比，分 析术前CT灌注成像在脑胶质瘤患者手术 治疗中的应用价值。方法 收集2014年7 月-2017年9月期间我院神经外科接受开颅 手术切除治疗的脑胶质瘤患者共81例，根 据术前CT检查方法分为灌注组45例、增强 组36例，分别行CT灌注、CT增强检查。 根据检查结果测量术前肿瘤面积，并进 行分级诊断，术后定期行CT灌注或CT增 强复查，比较两组复发情况。结果 灌注 组术前CT灌注肿瘤面积为(12.03±2.25) cm2 ，明显大于增强组术前CT增强肿瘤面 积为(10.54±1.98)cm2 (P＜0.05)。以术 后病理结果为标准，灌注组术前低级别、 高级别诊断准确率均明显高于增强组(P ＜0.05)。低级别、高级别患者健侧区CT 灌注参数脑血流量(CBF)和脑血容量(CBV) 及CT增强值无统计学差异(P＞0.05)，但 高级别患者病灶区CBF、CBV及CT增强值 明显高于低级别患者(P＜0.05)。灌注 组、增强组低级别患者术后1年内复发率 (10.00% vs 27.78%)无统计学差异(P＞ 0.05)，但灌注组高级别患者术后1年内复 发率(16.00% vs 44.44%)明显低于增强组 (P＜0.05)。结论 术前CT灌注成像有助于 明确脑胶质瘤病灶范围，提高术前分级诊 断准确性，继而可有效降低术后复发率， 具有较高的应用价值。

Objective To analyze the application value of preoperative CT perfusion imaging in the surgical treatment of glioma patients. Methods A totaol of 81 patients with glioma undergoing craniotomy in neurosurgery department of our hospital from July 2014 to September 2017 were selected. According to the preoperative CT examination method, 45 patients were divided into perfusion group, 36 patients were rolled into the enhanced group. All of them were given CT perfusion and CT enhancement examination. The grading diagnosis was performed according to the size. CT perfusion or CT enhanced examination were performed after surgery, the recurrence of the two groups was compared. Results The preoperative CT perfusion tumor area in the perfusion group was (12.03±2.25) cm2 , significantly greater than the preoperative CT enhanced tumor area in the enhanced group (10.54±1.98) cm2 (P<0.05). Taking the postoperative pathological results as the standard, the diagnosis accuracy of low-grade and high-level in the perfusion group was significantly higher than that in the enhanced group (P<0.05). There was no significant difference in cerebral blood flow (CBF), cerebral blood volume (CBV) and CT enhancement value between the low-grade and high-grade patients in CT perfusion parameters of contralateral area (P>0.05), the CBF, CBV and CT enhancement values in the focal area of high-grade patients were significantly higher than those of the lowgrade patients (P<0.05). There was no significant difference in the recurrence rate (10.00% vs 27.78%) of the low-grade patients in the perfusion group and the enhanced group (P>0.05), the recurrence rate of the high-grade patients in the perfusion group within 1 year (16.00% vs 44.44%) was significantly lower than that in the enhanced group (P <0.05). Conclusion Preoperative CT perfusion imaging helps to define the extent of glioma lesions, and improve the diagnostic accuracy of preoperative grading, and reduce the postoperative recurrence rate.