Abstract: Objective To explore the prediction of hemorrhage in brain neoplasms by microvascular permeability with perfusion CT imaging. Methods Retrospectively analysed the perfusion CT of 24 cases of tumors in central nervous system (CNS) confirmed by operation and pathological examination. There were 10 cases with hemorrhage and 14 cases without hemorrhage in brain neoplasms. The relationship between the permeability surface (PS) and hemorrhage in brain neoplasms was observed and analysed. Results The lesion size varied from 3 to 8 cm. The tumors showed iso- or hypo-density, and hemorrhage lesion presented hyper-density on CT plain scan. On enhanced scans, hemorrhage in tumor showed phanero-enhancement, while tumor presented heterogeneous enhancement. The hemorrhage lesion was rich in blood supply. PS value of hemorrhage in brain neoplasms [(24.55 ± 4.74) ml/(100 g·min)] were significantly higher than that without hemorrhage [(15.06 ± 5.48) ml/(100 g·min); t = 4.412, P = 0.001]. Conclusion Microvascular permeability can quantify the defect of blood-brain barrier (BBB) at tumor lesion. The position where PS value increases obviously may predict the risk for hemorrhage in brain neoplasms.

Key words: Brain neoplasms, Stroke, Capillary permeability, Tomography, spiral computed

摘要： 目的   探讨应用CT 灌注微血管通透性技术预测脑肿瘤卒中的可能性。方法   对经手术和病理证实的24 例中枢神经系统肿瘤患者（瘤卒中10 例，非瘤卒中14 例）的CT 灌注影像学资料进行回顾分析，分析肿瘤表面通透性与瘤卒中之间的关联性。结果   肿瘤直径为3 ~ 8 cm，CT 扫描肿瘤呈等或低密度影，肿瘤内出血灶为高或略高密度影；增强扫描肿瘤呈不均匀强化，出血部位明显强化；CT 灌注成像肿瘤出血部位血运丰富，瘤卒中患者表面通透性测值为（24.55 ± 4.74）ml/（100 g·min），明显高于非瘤卒中患者（15.06 ± 5.48）ml/（100 g·min），二者差异具有统计学意义（t = 4.412，P = 0.001）。结论   微血管通透性可以量化肿瘤血-脑屏障的损伤程度，肿瘤表面通透性测值明显增高的部位可能预示存在出血风险。

关键词: 脑肿瘤, 卒中, 毛细血管通透性, 体层摄影术, 螺旋计算机