CT灌注成像在短暂性脑缺血发作的临床应用价值  

The clinical application value of CT cerebral perfusion imaging in transient ischemic attacks

作　　者：胡春洪[1] 吴庆德[1] 杨振贤[1] 沈海林[1] 傅引弟[1] 董万利[1] 刘禄清[1] 滕金宝[1] 高亚枫[1] 徐正昌[1] 丁乙[1] 

机构地区：[1]苏州大学附属第一医院影像中心,江苏苏州215006

出　　处：《医学影像学杂志》2005年第9期734-737,共4页Journal of Medical Imaging

摘　　要：目的:探讨CT脑灌注成像在短暂性脑缺血发作(TIA)的应用价值。方法:对15例临床诊断TIA的病人行CT灌注成像,在常规轴面CT扫描后根据临床症状选取4个相邻的兴趣层面,团注对比剂4s后开始持续50s的连续动态扫描,重建的200幅动态图像使用脑灌注软件包进行处理,获得灌注图像。测量脑内感兴趣区的到达峰值时间、血流量和血容量,对这些图像进行定量分析。结果:TIA患者中有8例发现与临床症状相对应的灌注异常区,表现为达峰时间延迟和/或血流量下降;另外7例未发现灌注异常区。15例患者患侧与对侧的平均达峰时间分别为(12.01±3.53)s和(10.31±2.68)s,经配对t检验:t=3.68,P<0.01,两者间差异具有显著性意义;两侧平均血容量间的差异无统计学意义。结论:CT脑灌注成像能够为TIA患者提供有价值的脑血流动力学信息,显示灌注异常的范围。Objective：To explore the value of CT perfusion imaging on transient ischemic attacks （TIA）. Methods： CT cerebral perfusion was performed on 15 patients with clinically diagnosed TIA. At 4 s after initiation of the injection, a cine scan was initiated on four adjacent interested sections for a duration of 50 s. These 200-slice dynamic images were processed with the “perfusion CT” software package. Regional time-to-peak （rTP） ,regional cerebral blood flow （rCBF） and regional cerebralblcod volume （rCBV） were measured within specific regions of interest of the brain on CT peffusion images. And quantitative analysis was performed. Results：In 15 cases with T/A, persisting abnormal perfusion changes corresponding to clinical symptoms were found in 8 cases with prolonged rTP and/or dropped rCBF. Other 7 cases showed normal results. The rTP of affected side （12.01 ± 3.53）s compared with that of the contralateral side （10.31 ± 2.68）s was significantly prolonged （ t =3.68, P 〈0.01）. The difference of the rCBV （ t =0.19, P 〉0.05） was not statistically significant between both sides. Conclusion： Perfusion CT provides valuable hemedynamic information and shows the extent of perfusion disturbances for patients with TIA.

关 键 词：脑缺血 暂时性 血液动力学 体层摄影术 X线计算机 

分 类 号：R743[医药卫生—神经病学与精神病学] R814.42[医药卫生—临床医学]