短暂性脑缺血发作的动态CT灌注成像与缺血再发作的关系  

The study on dynamic CT perfusion imaging and in recurrence of TIA

作　　者：谭琦[1] 孙凌瑜[1] 何国荣[1] 黄如训[2] 陈豪[1] 彭全[1] 唐劭年[1] 李哲[1] 胡宗继[1] 

机构地区：[1]中山大学附属东华医院神经内科,东莞523110 [2]中山大学附属第一医院神经内科

出　　处：《中国神经精神疾病杂志》2010年第1期5-9,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：东莞市科技基金项目(编号:200614)

摘　　要：目的探讨短暂性脑缺血发作(transient ischemic attack,TIA)患者CT灌注成像(CT perfusion,CTP)的变化,为预防TIA再发提供判断依据。方法经临床确诊的TIA患者20例于急性期先行常规16排螺旋CT横断面平扫,然后根据累及的动脉系统,选择感兴趣平面行脑CT灌注扫描,同时行CT血管造影。1个月后复查脑CT灌注。结果20例患者中,在急性期大部分患者患侧局部脑血流(regional cerebral blood flow,rCBF)呈轻到中度异常,患侧局部脑血容量(regional cerebral blood volume,rCBV)呈正常或轻度下降。1个月后复查CT脑灌注结果显示有12例患者未发现异常,8例患者rCBF呈轻到中度下降,患侧rCBV呈正常或轻度下降,随访1年,14例未复发。6例两次CT灌注均有异常者在1年内有5例TIA再发,1例发展为脑梗死。结论对于脑灌注量降低严重而且持续时间长的TIA患者,提示可能出现TIA再发或进展为脑梗死,应及时强化抗缺血治疗。Objective Evaluation of cerebral blood flow in patients with transient ischemic attack （TIA） using cerebral CT perfusion imaging. Methods CT perfusion scan was performed on a consecutive series of 20 patients with clinical definite TIA. Following their initial CT scan at acute stage of TIA, patients underwent two repeat CT perfusion scanning of region of interest at acute stage and one month after symptom remission. Results Mild to moderate decrease in regional cerebral blood flow （rCBF） and unchanged or mildly decrease in regional cerebral blood volume （rCBV） were observed at acute stage in the majority cases. Normal cerebral perfusion was found in 12 cases and mild to moderate decrease of rCBF in 8 cases one month after TIA. During the one - year follow - up period, all of 12 cases with normal cerebral perfusion did not have recurrence while among 8 cases with mild to moderate decrease of rCBF at initial scan, 6 cases had recurrent TIA or cerebral infarction and 2 cases did not have recurrence. Patients with more severe cerebral perfusion defects usually had a shorter interval time between two attacks. Conclusions Intensive intervention should be performed on patients with severe and long lasting decrease of cerebral perfusion.

关 键 词：短暂性脑缺血发作 再发 CT灌注显像 

分 类 号：R743.31[医药卫生—神经病学与精神病学]