脑CTP联合头颈CTA对脑卒中侧支循环诊断的价值  

Value of Brain CTP Combined with Head and Neck CTA on Diagnosis of Collateral Circulation of Cerebral Apoplexy

作　　者：陈志军[1] 梁立华[1] 林景兴 吴菊芳[1] 冯晓荣[1] 

机构地区：[1]深圳市福田区人民医院放射科,广东深圳518033

出　　处：《中国CT和MRI杂志》2016年第3期44-47,67,共5页Chinese Journal of CT and MRI

摘　　要：目的探讨脑CTP联合头颈CTA诊断急性缺血性脑卒中侧支循环的方法及应用价值。方法收集拟诊急性脑梗死患者50例,患者完成CTA、CTP检查后及时行相关临床治疗。30天后复查头颅CT或MRI平扫。尝试以"CBV-TTP不匹配,且delay TTP>6s"方法来判断半暗带,以CBV不变或轻度升高,TTP明显延迟及CTA判断侧支循环。结果 TP-CBV诊断半暗带敏感度95%,特异性69%;CTP诊断侧支循环与CTA比较,差异无统计学意义(P>0.05),敏感度76%,特异性81%。结论 CBV-TTP不匹配,且delay TTP>6s"方法诊断半暗带准确性较高,CTP诊断侧支循环准确性较高。脑CTP联合头颈CTA对急性缺血性脑卒中侧支循环的诊断有较高的应用价值。Objective To evaluate the methods and value in diagnosing collateral circulation of Acute ischemic stroke with CT perfusion and CT angiography. Methods A total of 50 patients suspected with acute cerebral infarction were collected, After underwent CTA and CTP, timely clinical treatment were took. The head CT or MRI scan was took 30 days after onset. Attempt to defind the penumbra with ＂CBV-TTP mismatch, and delay TTP6s＂, compared with review; and determine the collateral circulation with CBV unchanged or slightly elevated, TTP significantly delayed, compare with CTA, evaluated the diagnostic value of CTP. Results As CTP diagnosing penumbra, compared with the results of the review, the difference was not statistically significant（P〈0.05）, with a sensitivity of 95% and a specificity of 69%; As CTP diagnosing the collateral circulation, compared with CTA, the difference was not statistically significant（P〈0.05）, sensitivity 76%, specificity of 81%. Conclusion Higher accuracy was found with method ＂CBVTTP does not match, and delay TTP6s＂ to diagnose penumbra, as well as CTP to assess collateral circulation. CTP combined CTA for acute stroke has a high value.

关 键 词：64层螺旋CT CT灌注成像 CT血管成像 急性缺血性脑卒中 

分 类 号：R445.3[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]