CT灌注和CT血管成像在缺血性卒中早期诊断中的作用  

The application of CT perfusion imaging and CT angiography in early ischemic stroke

作　　者：王芃[1] 齐景伟[2] 甄勇[1] 昌镜辉 索耀华 李铁男[1] 

机构地区：[1]长春市中心医院神经外科,130051 [2]长春市中心医院影像科,130051 [3]长春市客车厂职工医院

出　　处：《中国脑血管病杂志》2005年第9期389-392,共4页Chinese Journal of Cerebrovascular Diseases

摘　　要：目的探讨CT灌注和CT血管成像对缺血性卒中患者早期诊断缺血半暗带和缺血部位的作用。方法回顾20例缺血性卒中患者,于发病24h之内均行CT灌注检查,8例行CT血管成像,获取梗死侧与正常侧脑血流量(CBF)、脑血容量(CBV)和平均通过时间(MTT)参数图和脑血管影像,将上述结果进行统计学分析。结果本组急性脑梗死16例,4例TIA患者,经CT灌注检查梗死侧缺血中心区的CBV、CBF为(2.1±0.6)ml/100g、(22.8±26.2)ml.100g-1.min-1,较正常侧明显减少,MTT为(7.6±3.2)s,与正常对照区相比差异有显著性(P<0.01)。15例可见缺血半暗带存在,CT血管成像8例,与CT灌注判断的梗塞血管基本相符。结论CT灌注成像能快速、准确反映缺血半暗带的部位、范围,结合CT血管成像,可以准确判断栓塞血管部位,对早期诊断缺血性卒中和抓住动脉溶栓时机有较好的指导作用。Objective To investigate the effect of computed tomography perfusion （CTP） imaging and computed tomography angiography （CTA） in detecting ischemic penumbra and location of early ischemic stroke. Methods 20 patients of acute ischemic stroke were reviewed. CTP were applied for all of them and CTA were added in 8 cases within 24 hour after onset. Cerebral blood flow and cerebral blood volume were measured, the mean transmit time （MTF） and cerebrovascular image were analyzed. Results CBF and CBV were decreased as well as MTT were delayed in the ischemic center and ischemic penumbra in 16 cases of acute cerebral infarction and 4 cases of TlA, compared to normal side of brain, ischemic penumbra were found in 15 eases. With CTA, occlusion of local vessels was confirmed in the same area as CTP showed in 8 of 15 cases. Conclusion CTP imaging can accurately and clearly to show the location and range of ischemic penumbra, together with CTA, can play an important part in diagnosis of acute ischemic stroke and guide the selection of local intra-arterial thrombolytic therapy.

关 键 词：体层摄影术 X线计算机 脑梗塞 诊断显像 灌注 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R816[医药卫生—临床医学]