CT灌注成像血管表面通透性评价急性脑梗死  

CT microvascular permeability surface imaging evaluation of acute cerebral infarction

作　　者：戴峰[1] 高歌军[2] 卢万俊[3] 

机构地区：[1]东南大学附属南京市第二医院放射科,江苏南京210008 [2]东南大学附属中大医院放射科,江苏南京210009 [3]东南大学附属中大医院神经内科,江苏南京210009

出　　处：《中国医学影像技术》2010年第3期456-459,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨CT灌注成像中血管表面通透性(PS)在急性脑梗死中的应用。方法对30例急性和亚急性脑梗死患者行脑CT灌注成像(CTP)联合CT血管成像(CTA),比较患侧与健侧脑血流动力学参数[脑血流量(CBF)、脑血容量(CBV)、达峰时间(TTP)、PS]的差异,分析梗死侧血管通透性增高表现。结果急性脑梗死灶核心区与健侧正常脑组织脑血流动力学参数比较差异有统计学意义(P<0.05)。梗死周围脑组织与健侧脑组织CBF和CBV比较差异无统计学意义,而TTP和PS呈延迟和增高改变,差异有统计学意义(P<0.05)。3例患者治疗后在行常规CTP后延迟30 min平扫,可见梗死区域内高密度对比剂外渗改变,其PS值高达(9.20±1.43)ml/100(ml.min)。结论CT血管PS血流动力学指标可用于脑梗死继发出血或脑出血转化的监测,指导临床溶栓治疗。Objective To investigate the application of CT microvascular permeability surface（PS） in acute ischemic stroke.Methods Thirty patients suffering from acute or sub-acute cerebral infarction underwent CT perfusion（CTP） combining with CTA.Cerebral hemodynamic parameters（cerebral blood flow ,cerebral blood volume ,time to peak ,PS） between lesions and contralateral side were compared.The manifestation of microvascular hyper permeability were analyzed.Results Significant differences were found in cerebral hemodynamic parameters between the core of cerebral infarction and the contralateral hemisphere（P 0.05）.There was no significant difference in CBF and CBV between the surrounding of cerebral infarction and the contralateral hemisphere,but PS and TTP showed delaying and heightening,the difference was significant（P 0.05）.High-density extravasation of contrast media in infarction zone was observed 30 min after CTP in 3 patients,the value of PS reached（9.20±1.43） ml/100（ml·min）.Conclusion CT microvascular PS may monitor hemorrhagic transformation in acute ischemic stroke,and guide thrombolytic therapy.

关 键 词：体层摄影术 X线计算机 灌注成像 表面通透性 脑梗死 血流动力学 

分 类 号：R814.42[医药卫生—影像医学与核医学] R743.33[医药卫生—放射医学]