64层螺旋CT灌注成像和血管成像在急性缺血性脑卒中的应用  

The application of 64-multidetector spiral CT cerebral perfusion imaging and CT angiography in patients with acute ischemic stroke

作　　者：赵惠荣[1] 郭晶[1] 郑秀芬[1] 元小冬[1] 郭庆乐[1] 

机构地区：[1]河北联合大学附属开滦总医院,唐山063000

出　　处：《中国实用神经疾病杂志》2015年第11期1-3,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的：探讨64层螺旋CT 灌注成像（CTP）、CT血管成像（CTA）在急性缺血性脑卒中的应用价值。方法对30例急性缺血性脑卒中患者，于发病12 h内行头CT平扫、CTP、CTA检查，分析平扫及灌注CT表现，计算灌注缺损区CBF、CBV、MTT各参数值，与对侧相应区灌注参数进行比较，重建颈段和脑内动脉CTA图像，并于发病2～7 d复查CT平扫。结果30例急性缺血性脑卒中患者，15例C T平扫未发现异常，14例可见腔隙梗死灶或软化灶，1例可见脑梗死早期低密度改变。10例C T P未见明显异常，20例C T P发现与临床症状相对应的大小不等的灌注减低区，18例可见不同范围缺血半暗带。CTA 显示12例未见明显异常，18例可见血管狭窄或闭塞。结论 CTP、CTA能够快速准确反映缺血部位及范围，显示缺血半暗带，判断闭塞血管，对早期诊断急性脑梗死和指导溶栓治疗具有重要价值。Objective To evaluate the application value of CT perfusion imaging and CT angiography in acute ischemic stroke. Methods Routine CT scan ,CTP and CTA were performed in 30 patients with acute ischemic stroke within 12 hours after symptom onset ,perfusion parameters of CBF ,CBV and MTT were measured and the parameters were compared with the opposite sides of brain regions. CTA was constructed to show carotid and intra cerebral arteries. All patients were re‐examined cerebral plain CT after 2‐7 days. Results Conventional plain CT of the 30 cases found negative results in 15 cases ,small lacu‐nar infarction in 14 cases and early low density change sign in 1 case. CTP was not seen the exception in 10 cases. CTP found differ perfusion reduce area corresponding to clinical symptoms in 20 patients ,18 cases were seen different area penumbra. CTA showed apparently unusual has not seen in 12 patients ,the vascular narrowing or block in 18 cases. Conclusion CTP can quickly and accurately show the position ,area and the range of the ischemic lesion and penumbra. CTP should be meaningful for the early diagnosis of acute cerebral infarction and guiding thrombolytic treatment.

关 键 词：CT灌注成像 CT血管成像 急性缺血性脑卒中 半暗带 

分 类 号：R743.3[医药卫生—神经病学与精神病学]