脑CTA与CT灌注成像在TIA病因诊断中的价值  

The value of CT angiography and CT perfusion imaging in brain in etiological diagnosis of TIA

作　　者：钟井松[1] 沈海林[2] 丁乙[2] 陆敬民[3] 沈雪峰[3] 杨益龙[4] 王虹[1] 

机构地区：[1]江苏省淮安市第二人民医院CT室,江苏淮安223002 [2]江苏省苏州大学附属第一医院影像中心,江苏苏州215006 [3]江苏省淮安市第二人民医院神经科,江苏淮安223002 [4]江苏省淮安市第二人民医院介入科,江苏淮安223002

出　　处：《医学影像学杂志》2010年第6期774-778,共5页Journal of Medical Imaging

摘　　要：目的:探讨脑CT血管造影与CT灌注成像在短暂性脑缺血发作(transient ischemic attack,TIA)病因诊断中的价值。方法:对20例临床诊断为TIA的患者行64-SCTP检查及头颈部64层CT血管造影(64-SCTA)检查,前循环TIA11例,后循环TIA9例,测定兴趣区及对侧相应区域局部脑血流量(rCBF),局部脑血容量(rCBV),平均通过时间(MTT)和达峰时间(TTP)。结果:20例患者头颅CT平扫均未发现与临床症状相对应的病灶,但有13例CT脑灌注成像发现与临床症状相对应的异常灌注区,其中10例前循环TIA患者发现灌注异常区,TTP、rCBF、MTT值与健侧对照区差异均有显著性意义(P<0.05),rCBV与健侧对照区差异无显著性意义(P>0.055);3例后循环TIA患者发现枕叶有灌注异常;CTA发现10例前循环血管狭窄,6例后循环血管狭窄。结论:脑64-SCTP成像可以多参数评估TIA患者血流动力学改变,以TTP及MTT最敏感,CBF次之;脑64-SCTP结合头颈部CTA,对TIA病因诊断有着重要的临床价值。Objective：To expore the value of CT angiography and CT perfusion imaging in brain in etiological diagnosis of transient ischemic attack（TIA）.Methods：64-SCTP and 64-SCTA were performed in 20 patients with TIA diagnosed by neuroscience physicians.In all the 20 patients,there were 11 patients with internal carotid artery system TIA and 9 patients with vertebral basilar artery system TIA.64-SCTP was used to calculate TTP,rCBF,rCBV and MTT in region of interest（ROI） and corresponding areas of the opposite side.Results：Focus was not found by CT plain scan in areas corresponding to their clinical symptoms in all 20 patients,13 cases of the 20 patients were found abnormal perfusion changes corresponding to clinical symptoms by CTP.The differences of the TTP,rCBF,MTT in affected side compared with that of the contralateral side were significance（P〈0.05）.The difference of the rCBV was not statistically significant between both sides（P〉0.05）.3 cases with vertebral basilar artery TIA were found abnormal perfusion changes in occipital lobe;10 cases were found hemadostenosis in internal carotid artery system and 6 cases were found hemadostenosis in vertebral basilar artery system by CTA.Conclusion：64-slice spiral CT perfusion in brain can evaluate the hemodynamics of patients with TIA by multiparameter.TTP and MTT are the most sensitive.64-slice spiral CT perfusion in brain combined CTA in pate has great value for etiological diagnosis of TIA.

关 键 词：血管造影术 灌注 短暂性脑缺血发作 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]