目的：探讨MSCT对脑过度灌注综合征(cerebral hyperperfusion syndrome,CHS)的预测、预防以及动态观察的意义。方法回顾性分析8例CHS患者的临床资料及影像学资料。结果8例中，动脉溶栓术后及DSA筛查术后各发生3例、颈动脉支架植入术后及动脉瘤弹簧圈填塞术后各发生1例。分别观察其超早期(1小时内)、早期(24小时内)、中期(1-5天)和晚期(＞5天)的MSCT动态表现：4例脑梗死患者术后超早期发生急性脑出血，3例脑出血逐渐吸收；1例脑出血早期增多并伴脑疝形成，中、晚期逐渐加重后死亡。4例脑出血患者术后，2例超早期出现脑水肿及脑肿胀，其后逐渐吸收至恢复；1例出血量逐渐增多，晚期略有吸收；另1例出血量在超早期明显增多并出现脑水肿及脑肿胀，其后症状无改善，家属最终放弃治疗后死亡。结论 MSCT在预测、预防CHS的发生、发展中具有重要价值，应列入常规检查；MSCT动态观察是显示CHS演变过程的最可靠、最直观的检查手段，可为治疗和判断预后提供重要依据。%Objective To investigate the signiifcance of MSCT in the prediction, prevention and dynamic observation of cerebral hyperperfusion syndrome (CHS). Methods The clinical and imaging data of 8 patients with CHS were analyzed retrospectively. Results In 8 cases, 1 cases occurred after arterial thrombolysis and DSA screening after the operation, 3 cases of carotid artery stenting and coil embolization of aneurysm after operation. Were observed in the ultra-early (1 hour) and early (within 24 hours), middle (1 to 5 days) and late (>5 days) of MSCT dynamic performance:4 cases of cerebral infarction patients with ultra-early occurrence of acute cerebral hemorrhage, 3 cases of cerebral hemorrhage absorbed gradually;1 cases intracerebral hemorrhage in early stage and increased with cerebral hernia formation, middle and late gradually increased after death. In 4 cases after cerebral hemorrhage patients, 2 cases of ultra-early appeared cerebral edema and swelling, thereafter gradually absorbed to restore;1 with gradual increase in the amount of bleeding, advanced slightly to absorb;the other 1 case bleeding in super early period increased markedly and brain edema and brain swelling, followed by symptoms non improvement. The family eventually gave up treatment after death. Conclusion MSCT in prediction and prevention of CHS, the development has an important value, should be included in the routine examination;MSCT dynamic observation is display CHS evolution process of the most reliable and the most intuitive means of inspection, can provide an important basis for treatment and prognosis.
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