64层螺旋CT脑灌注成像诊断急性脑缺血性疾病  

Diagnosis of Acute Ischemic Cerebrovascular Diseases with 64-slice CT Perfusion

作　　者：明小春[1] 陈观尚[1] 田执南[1] 

机构地区：[1]广东省湛江中心人民医院CT,MR室,广东湛江524037

出　　处：《现代医用影像学》2015年第2期194-197,共4页Modern Medical Imageology

摘　　要：目的探讨64层螺旋CT脑灌注成像在急性脑缺血性疾病中的诊断价值。材料与方法20例急性脑缺血性疾病的患者行64层螺旋头颅CT平扫、CT脑灌注成像(CT perfusion,CTP)检查,将CT平扫图像与CTP图像及各参数比较,同时梗死区与周围半暗带及健侧各CTP参数比较。结果首次头颅CT平扫发现脑梗塞病灶12例,复查头颅CT检出腔隙性脑梗塞2例;CTP发现18例病灶,2例腔隙性脑梗塞CTP未见异常。在灌注异常的CTP图像中,测定病灶中央、周围区及健侧的脑血流量(CBF)、脑血容量(CBV)、对比剂平均通过时间(MTT)及达峰时间(TTP),病灶中央与周围区、病灶与健侧对比差异有统计学意义(P<0.05)。结论64层螺旋CT脑灌注成像能提高急性脑缺血性疾病病灶的检出率。分析CTP各参数可区分脑梗死区及缺血半暗带,有助于临床对治疗方案的选择及对预后的判断。Purpose To explore the value of brain perfusion with 64-slice computered tomography （CT） in Diagnosis of acute ischemic cerebrovascular diseases . Materials and Methods 20 patients diagnosed as acute isehemic cerebrovascular diseases underwent plain CT and CT perfusion （CTP） . Compare plain CT with The CT perfusion parameters, then compare infarction area with ischemic penumbra and the contralateral. Results 12 eases cerebral infarcts were detected with plain CT, and another 2 eases cerebral infarcts were detected with the plain CT review . 18 cases cerebral infarcts were detected CTP , and 2 cases lacunar infarction were not detected with CTP. With the CTP, detected CBF, CBV, MTT and TI＇P in the central and the surronding of the infarct and the contralaterai , and the differences were statistically significant（ P 〈 0. 05 ） . Conclu- sion 64-slice CT perfusion could improve the detection rate of acute ischemic cerebrovascular diseases . CTP parameters can distinguish infarcts and ischemic penumbra , and it help Clinical choice of treatment.

关 键 词：体层摄影术 X线计算机 脑灌注成像 急性缺血性疾病 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R816.1[医药卫生—临床医学]