64层CT灌注成像对短暂性脑缺血发作患者的血流动力学评价  

64-Slice Spiral CT Perfusion in Evaluation of Hemodynamics in 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]淮安市第二人民医院CT室,江苏淮安223002 [2]淮安市第二人民医院神经科 [3]淮安市第二人民医院介入科 [4]苏州大学跗属第一医院影像科,江苏苏州215006

出　　处：《中国医学影像学杂志》2010年第5期420-425,共6页Chinese Journal of Medical Imaging

基　　金：江苏淮安市科技局科技支撑计划基金资助(编号:HAS2009001-4)

摘　　要：目的:探讨64层CT灌注(64-SCTP)成像对评价短暂性脑缺血发作(TIA)患者脑血流动力学变化的价值。材料和方法: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,其中,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),评价TIA患者脑血流动力学变化。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,CTP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与健侧对照区差异均无显著性意义(P>0.05);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成像可以用于评价TIA患者血流动力学改变;脑64-SCTP结合头颈部CTA对TIA病因诊断及病情评估有着重要的临床价值。Purpose To expore the value of 64-slice spiral CT perfusion（64-SCTP）in the evaluation of hemodynamics in transient ischemic attack（TIA）.Materials and Methods 64-SCTP and 64-SCTA were performed in 20 patients with TIA diagnosed by neuroscience physicians,Of 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 and the hemodynamics of the patients with TIA were evaluated.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 of affected side compared with that of the contralateral side was significance（P〈0.05）.The difference of the rCBV（P〉0.05）was not statistically significant between both sides.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 be used to evaluate the hemodynamics of patients with TIA,64-slice spiral CT perfusion in brain combined CTA in pate has great value for etiological diagnosis and evaluating pathogenetic condition of TIA.

关 键 词：脑缺血发作 短暂性 CT灌注成像 体层摄影术 螺旋计算机 血液动力学 现象 

分 类 号：R743.310.454[医药卫生—神经病学与精神病学]