CT脑灌注成像在短暂性脑缺血发作的初步研究  

The preliminary study of CT cerebral perfusion imaging in transient ischemic attacks

作　　者：卢洁[1] 李坤成[1] 杜祥颖[1] 

机构地区：[1]首都医科大学附属宣武医院放射科,首都医科大学博士研究生100053

出　　处：《中华放射学杂志》2002年第4期330-333,共4页Chinese Journal of Radiology

摘　　要：目的　探讨CT脑灌注成像在短暂性脑缺血发作 (TIA)的应用。方法　对 5例正常人及2 0例临床诊断TIA的病人行常规CT头颅平扫及CT脑灌注成像。在常规轴面CT扫描后一般选取基底节层面 ,经肘静脉团注对比剂 ,同时开始持续 40s的单层连续动态扫描 ,重建的 40幅动态图像使用CT脑灌注软件包进行处理 ,获得灌注图像。测量脑内感兴趣区的到达峰值时间及血流量 ,对这些图像进行定量分析。结果　CT脑灌注成像显示脑灰质灌注高于脑白质。正常人脑灰质的血流量及达峰时间分别为 378 2ml·min-1·L-1、7 8s ;脑白质分别为 112 5ml·min-1·L-1、9 9s。 2 0例TIA患者中有 15例发现与临床症状相对应的灌注异常区 ,表现为达峰时间延迟 ;另外 5例未发现灌注异常区。2 0例患者患侧局部灌注达峰时间 (TP)延长及对侧的平均达峰时间分别为 (11 8± 4 4)s和 (9 1±3 1)s,经配对t检验 :t=5 2 77,P <0 0 1;脑血流值分别为 (2 2 3 5± 38 7)ml·min-1·L-1和 (2 2 9 1±41 4)ml·min-1·L-1,经配对t检验 ;t=1 892 ,P =0 0 74。结论　CT脑灌注成像能够为TIA患者提供有价值的脑血流动力学信息 ,显示灌注异常的范围。Objective To probe the application of CT cerebral perfusion imaging on transient ischemic attacks(TIA) Methods Conventional CT and CT cerebral perfusion imaging were performed on 5 normal adults and 20 patients with clinically diagnosed TIA After regular CT examination, dynamic scans of 40 seconds were performed on selected slice (usually on the basal ganglia slice), while 40 ml non ionic contrast material were bolus injected through antecubital vein with These dynamic images were processed with the 'Perfusion CT' software package on a PC based workstation Cerebral blood flow (CBF) and time to peak (TP) enhancement were measured within specific regions of the brain on CT perfusion images Quantitative analysis was performed for these images Results A gradient of perfusion between gray matter and white matter was showed on CT perfusion images in normal adults and TIA patients CBF and TP for normal cortical and white matter were 378 2 ml·min -1 ·L -1 , 7 8 s and 112 5 ml·min -1 ·L -1 , 9 9 s, respectively In 20 cases with TIA, persisting abnormal perfusion changes corresponding to clinical symptoms were found in 15 cases with prolonged TP Other 5 cases showed normal results TP of affected side (11 8±4 4) s compared with that of the contralateral side (9 1±3 1) s was significantly prolonged ( t =5 277, P <0 01) The difference of the CBF was not statistically significant ( t =1 892, P =0 074) between affected side [(223 5±38 7) ml· min -1 ·L -1 ] and contralateral side [(229 1±41 4) ml· min -1 ·L -1 ] Conclusion Perfusion CT provides valuable hemodynamic information and shows the extent of perfusion disturbances for patients with TIA

关 键 词：CT脑灌注成像 暂时性脑缺血 血液动力学 X线计算机摄影术 TIA 

分 类 号：R743[医药卫生—神经病学与精神病学]