Liu Tiantian, Qian Wenxia, Jiang Yan, Yang Ying, Ding Yanping
Department of Imaging, Wuxi Ninth People's Hospital Affiliated to Soochow University, Wuxi, 214000, China.
Department of Imaging, Kunshan Traditional Chinese Medicine Hospital, Kunshan, 215300, China.
Sci Rep. 2025 Apr 22;15(1):13993. doi: 10.1038/s41598-025-99241-z.
Severe traumatic brain injury (sTBI) is a significant public health concern with high disability and mortality rates. No reliable diagnostic tools exist to determine surgical indications or predict prognosis. To assess the clinical value of computed tomography angiography (CTA) and perfusion (CTP) in sTBI, and compare treatment efficacy based on traditional imaging versus CTA/CTP assessment. This retrospective study included 169 patients with sTBI who underwent CTA/CTP at admission and postoperatively to guide treatment decisions. Another 132 patients received treatment based on traditional imaging. Clinical outcomes and complications were compared between the two groups. Baseline characteristics did not differ significantly between groups. Although the 6-month Glasgow outcome scale (GOS) scores were comparable, in-hospital mortality was lower in the CTA/CTP group, and the craniotomy rate was significantly reduced. A higher proportion of patients who underwent the operation in the CTA/CTP group had favorable prognoses. Moreover, the hospitalization duration and costs were substantially lower in the CTA/CTP group. The CTA/CTP imaging provides critical cerebrovascular and perfusion data in sTBI, aiding in surgical decision-making and perioperative management.
重度创伤性脑损伤（sTBI）是一个重大的公共卫生问题，致残率和死亡率都很高。目前尚无可靠的诊断工具来确定手术指征或预测预后。为了评估计算机断层血管造影（CTA）和灌注成像（CTP）在sTBI中的临床价值，并比较基于传统影像学与CTA/CTP评估的治疗效果。这项回顾性研究纳入了169例sTBI患者，他们在入院时和术后接受了CTA/CTP检查以指导治疗决策。另外132例患者基于传统影像学接受治疗。比较了两组的临床结局和并发症。两组的基线特征无显著差异。尽管6个月时的格拉斯哥预后量表（GOS）评分相当，但CTA/CTP组的住院死亡率较低，开颅率显著降低。CTA/CTP组接受手术的患者中，预后良好的比例更高。此外，CTA/CTP组的住院时间和费用大幅降低。CTA/CTP成像为sTBI提供了关键的脑血管和灌注数据，有助于手术决策和围手术期管理。
