多层螺旋CT脑灌注成像超早期诊断急性脑梗死的临床研究  

Quantitavive assessment of acute cerebral infarction using multislice computed tomographyic perfusion imaging

作　　者：王合森[1] 陈润成[1] 徐炜华 朱平先[1] 向子云[1] 谭朝晖[1] 陈艺莉[1] 邹莲霞[1] 

机构地区：[1]深圳市龙岗区人民医院内科,广东深圳518172 [2]龙岗沙湾医院,广东深圳518000

出　　处：《中国医学工程》2003年第6期87-90,共4页China Medical Engineering

摘　　要：目的　应用多层螺旋CT(MSCT)借助特殊软件进行脑灌注成像 ,观察超早期急性脑梗死动态变化。方法　静脉注射 10 0ml碘海醇 ,应用西门子SENSATION4型多层螺旋CT ,对 2 3例发病 6h以内急性缺血性脑血管病扫描观察时间 -密度曲线 ,测定梗死区和对侧正常对照区的血流灌注值局部脑血流量 (rCBF) ,局部脑血流容积 (rCBV) ,平均通过时间 (MTT)等 ,并获得相应参数的脑灌注CT成像 ,所有病例至少在发病 1周后复查 1次普通CT。结果　 2 3例急性缺血性脑梗死患者中 2 0例其脑梗死侧rCBF比对侧显著降低 (P <0 .0 1) ,有 17例患者 1周后复查CT发现其最终梗死面积比 6h内脑灌注的面积有缩小 (P <0 .0 5 ) ,证明此组患者在梗死灶中心周围有缺血性半暗区存在 ,有 3例患者 1周后CT图像显示最终梗死面积与 6h内脑灌注成像面积无明显差异。结论　多层螺旋CT脑灌注成像可以在急性脑梗死发病 6h内超早期明确梗死灶部位及范围 ,以及发现缺血坏死灶周围是否存在缺血性半暗带。Objective:To value the use of multislice computed tomographyic(MSCT)perfusion imaging in the assessment of acute cerebral infarction.Methods:23 patients who initiailly diagnosed as acute cerebral infarction were intravenously injected 100～150 ml iodine each as acontrast agent in 6 hours after their outbreak of infarction. The siemens semsation 4 MSCT was used to scan the patients and form time versus concentration curve analysis of the various perfusion parameters, including the coparision of region cerebral blood flow (rCBF) , region cerebral blood volume(rCBV) and mean transit time(MTT) between the necrosis region and the normal region. As a result, dynamic perfusion images with various perfusion parameters were made throught perfusion compted tomography. Each case had to be examined by computed tomography once at least one week after his infarction.Results:20 patient of the 23 patients were found having a lower rCBF in their necrosis region compared with the other side( P <0.01), 17 patients were observed a shrink of the size of the infarction region compared the perfusion image in first 6 hours when they were counterchecked by CT a week later( P <0.05), which proves the exist of ischemic penumbra area around the infarction center. Only 3 cases indicated no obvious difference according to the CT image between the first 6 hours and a week later.Conclusions:The multislice computed tomographyic perfusion imaging technology can define the infarction region and it's size at the early stage of acute cerebral infarction. It also provides clues to indicate the exist of an avascular area around the necrosis centre.

关 键 词：多层螺旋CT(MSCT) 脑灌注成CT像(PCTI) 急性脑梗死超早期 诊断 

分 类 号：R445.3[医药卫生—影像医学与核医学]