64层螺旋CT三维脑灌注血容量在急性缺血性梗死中的应用  

Initial study of 3D perfused blood volume imaging using 64-detector CT in hyperacute cerebral infarction

作　　者：朱海云[1] 耿道颖[2] 

机构地区：[1]解放军第八五医院放射科,上海200052 [2]复旦大学附属华山医院放射科

出　　处：《国际医学放射学杂志》2010年第2期148-151,共4页International Journal of Medical Radiology

基　　金：上海市科委重点课题(074119504);南京军区2007年度医学科技创新课题(07M005)

摘　　要：目的探讨以CT血管成像（CTA）为基础的三维CT全脑灌注血容量（3D PBV）影像在急性脑缺血中的应用价值。方法38例0～12h发病病人,分别行CT平扫及CTA扫描。使用三维Neuro PBV软件处理CTA获得全脑血流灌注影像。CT检查完毕后2h内行MRI检查。分别用MRI、3D PBV、CT平扫计算梗死灶数目同时测量3D PBV与扩散加权成像（DWI）中梗死体积。分别比较平扫CT、3D PBV、MRI的梗死灶数目及测量3D PBV和MRI的梗死体积。结果38例入选病人中,MRI、3D PBV、CT平扫发现病灶的数目分别为45、41、16个;三者的Kappa分析结果κ值分别为0.24、0.18、0.78。3D PBV与MRI检测体积配对t检验结果为t=7.249,P〉0.05。结论3D PBV结合CTA可以较为全面地反映脑缺血病灶的范围及血管情况,在早期诊断脑缺血中具有重要价值。Objective To evaluate the value of three dimensional CT whole brain perfused blood volume（3D-PBV） based on CTA row data in hyperacute cerebral infarction.Methods 38 patients with stroke within 12 hours performed plain CT and CTA scans.3D software Neuro PBV was applied to process the CTA row data and 3D-PBV of brain was obtained.MR examinations were performed within 2 hours after CT scans.The numbers of ischemic lesions on plain CT,3D-PBV and MRI-DWI were recorded.The volumes of ischemic lesions on 3D -PBV and MR -DWI were measured.Results In 38 patients,the number of infarct lesion detected by MRI-DWI,PBV,and plain CT was 45,41,and 16 respectively.Kappa test showed a substantial agreement（κ=0.78） between 3D-PBV and MRI-DWI in detecting ischemic lesions.The detectability of plain CT showed fair or slight agreements to 3D-PBV and MR-DWI（κ=0.24,0.18,respectively）.The lesion volumes did not differ on 3D-PBV and MR-DWI（t=7.249,P0.05）.Conclusion 3D-PBV combined with CTA can detect ischemic lesion and evaluate perfusion.It had important value in diagnosing hyperacute cerebral infarction.

关 键 词：灌注 体层摄影术 X线计算机 脑梗死 磁共振成像 

分 类 号：R743.31[医药卫生—神经病学与精神病学]