CT灌注成像在脑内缺血性疾病中的初步应用  

The preliminary research of CT perfusion imaging in intraaxial ischemic disease

作　　者：刘翔 戴建平[1,2] 孙波 詹炯[1,2] 尚京伟 朱明旺[1,2] 张磊 胡平英[1,2] 张岩 张在强[1,2] 龙洁 

机构地区：[1]北京市神经外科研究所神经影像室 [2]北京天坛医院神经外科

出　　处：《中华放射学杂志》1999年第7期452-456,共5页Chinese Journal of Radiology

摘　　要：目的评价ＣＴ灌注成像在脑内缺血性疾病的作用。方法对２４例缺血性中风发作２小时至２个月的患者及１０例开颅术后的患者行常规ＣＴ扫描及ＣＴ灌注成像，２８例进行ＭＲＩ检查，６例行ＤＳＡ检查及单光子发射计算机体层成像（ｓｉｎｇｌｅｐｈｏｔｏｎｅｍｉｓｉｏｎｃｏｍｐｕｔｅｄｔｏｍｏｇｒａｐｈｙ，ＳＰＥＣＴ）。结果３４例患者ＣＴ平扫共检出３０个缺血及梗死灶，ＣＴ灌注成像共检出４１个病灶，均经随访ＣＴ、ＭＲＩ及ＳＰＥＣＴ证实。４０个病灶表现为最大峰值时间（ＰＴ）及平均通过时间（ＭＴＴ）较对侧延长，相对血流量（ＲＦ）明显减低（Ｐ＜００００１）。１个急性起病２周的病灶表现为最大峰值时间及平均通过时间较对侧缩短，相对血流量增高。结论结合常规ＣＴ及ＭＲＩ扫描，ＣＴ灌注成像不但有利于显示超急性期缺血性卒中病灶，还可观察Ｍｏｙａｍｏｙａ病、开颅手术损伤等脑内缺血性病灶的血流灌注变化。Objective To evaluate the application of CT perfusion in intraaxial disease Methods 34 cases intracranial ischemic disease (including 24 cases with stroke, 10 cases with postoperation ischemic lesions) were analyzed 19males, 15 females 34 cases with CT imaging and CT perfusion imaging, 28 cases with MRI examination, 6 cases with DSA snd SPECT examination Results There were 41 ischemic lesions on CT perfusion imaging, conformed by followup CT, MRI and SPECT images While only 30 on regular CT images 40 lesions with PT (longer peak time) and MTT (mean transit time), and lower RF (relative flow ) than opposite's, P<00001 Only one lesion-2 weeks after stroke onset with shorter PT and MTT and higher RF Conclusions Combined with regular CT and MRI images, CT perfusion imaging not only is useful in demonstrating the hyperacute ischemic stroke, but also can show the hemodynamic changes of intraaxial ischemic lesions caused by moya moya disease and craniotomy.

关 键 词：脑缺血 局部血流 CT 血流灌注成像 

分 类 号：R743.310.4[医药卫生—神经病学与精神病学] R816.1[医药卫生—临床医学]