320排CT全脑灌注成像对脑血管病变的应用价值  

The Application Value of Whole Brain Perfusion CT with 320-detector Row CT System in Patients with Cerebral Vascular Diseases

作　　者：陈明[1] 邢伟[1] 邱建国[1] 孙益芳[1] 丁玖乐[1] 

机构地区：[1]常州市第一人民医院影像科

出　　处：《中国医学计算机成像杂志》2013年第5期393-397,共5页Chinese Computed Medical Imaging

摘　　要：目的:探讨320排容积CT全脑灌注成像在脑血管病变中的应用价值。方法:利用320排容积CT对192例病例进行全脑灌注扫描,利用动态容积原始数据重建容积图像,减影后选择容积再现及最大密度投影方式获得脑血管重建图像,并利用软件生成相应的全脑灌注三维图像。结果:所有病例均获得良好的动态血管图像及全脑灌注图像,发现脑血管病变77例,其中动脉瘤30例,血管畸形15例,血管狭窄或闭塞32例。动脉瘤病例均经DSA证实,血管畸形病例经手术病理证实,10例血管栓塞病例行溶栓术后病理证实,22例血管狭窄经DSA证实。治疗前全部患者存在脑灌注异常区域,患侧与健侧比较,rCBV、rCBF减低,MTT延长,差异有统计学意义(P<0.05)。治疗后异常灌注区域rCBV、rCBF增高,治疗前后比较,差异有统计学意义(P<0.05)。结论:320排容积CT全脑灌注成像对于脑血管病变的诊断及随访具有较好的临床价值,可以实现对脑血管病变的全面评估。Purpose： To evaluate the application value of whole brain perfusion CT with 320-detector row CT system in patients suffering from cerebral vascular diseases. Methods： One hundred and ninety-two patients underwent whole-brain perfusion CT with 320-detector row CT system. Three-dimensional reconstructed cerebrovascular images were generated by volume rendering and maximum intensity projection techniques based on the subtracted raw images. And whole brain three-dimensional perfusion images were generate by on-site software. Results： The images of dynamic CTA and whole-brain perfusion images were obtained successfully. In 192 cases, 77 cases with cerebral vascular diseases were found by CTA, including aneurysm in 30 cases, vascular malformation in 15 cases and vascular stenosis or occlusion in 32 cases. Aneurysm cases were confirmed by DSA, vascular malformation cases were confirmed by pathology results. Ten patients with vascular thrombosis were confirmde by pathology findings after thrombolytic therapy. Twenty-two patients with vascular stenosis were confirmed by DSA. Before thrombolytic treatment, the regional cerebral perfusion abnormal in all patients was found by CTPI, rCBV and rCBF values of them were all decreased, and MTT values were increased. When compared the regional perfusion abnormal with contralateral normal region, the difference was with statistically significant （P〈0.05）. After treatment, rCBV and rCBF values were increased significantly when compared with that before treatment, the difference was with statistically significant （P〈0.05）. Conclusion： Whole-brain perfusion CT with 320-detector row CT system is of significant clinical value in diagnosis and following-up of cerebral vascular diseases.

关 键 词：体层摄影术 X线计算机 CT全脑灌注 CT血管造影术 脑血管病变 

分 类 号：R816.1[医药卫生—放射医学] R743[医药卫生—临床医学]