不同阶段缺血性脑梗塞CT影像学特点  

CT Imaging Findings of Different Stages of Ischemic Cerebral Infarction

作　　者：张志[1] 白琛[1] 骆伟[1] 

机构地区：[1]成都医学院第一附属医院放射科,四川成都610500

出　　处：《中国CT和MRI杂志》2016年第5期4-6,共3页Chinese Journal of CT and MRI

摘　　要：目的探讨不同阶段缺血性脑梗塞CT影像学特点。方法回顾性分析发病1-48h经临床确诊为缺血性脑梗塞患者57例的临床资料,入院时行首次CT检查,间隔24 h复查,分析CT影像学表现。结果本组57例患者,首次CT诊断发现28例异常(49.12%),24h后复查发现43例异常(75.44%),以大脑中动脉供血区堵塞为主。4例发病时间<6h,CT平扫无法清晰显示显示病灶,小部分患者脑会沟轻微变窄;16例发病时间6-24h,脑沟消失,灰白质无清晰边界,脑沟有不同程度的变浅;23例发病时间>24 h,病灶处为大中动脉为高密度,轻微占位现象,脑回不对称,部分中线结构改变,豆状核边缘不清晰,脑灰质密度降低,脑白质无清晰界线。结论不同阶段CT影像学表现不同,临床医师应提高对CT影像阳性特点的认识。Objective To investigate the CT imaging findings of different stages of ischemic cerebral infarction. Methods The clinical data of 57 patients with ischemic cerebral infarction clinically confirmed in 1～48h after attack were retrospectively analyzed. All patients were examined by CT and were reexamined every 24 h. CT imaging findings were analyzed. Results Among 57 patients in this study, the first CT diagnosis found that 28 cases were abnormal（49.12%）. 24 h later, reexamination found that 43 cases were abnormal（75.44%）, mainly was blockage in blood supply area of cerebral middle artery. There were 4 cases whose onset time was shorter than 6h and CT scan can not clearly show the lesions. Small part of the patients were with slight narrowing of cerebral sulci, The cerebral sulci of 16 patient whose onset time was 6～24h disappeared and the gray matter had no clear boundary. Cerebral sulci had different degrees of shallowing; The onset time of 23 patients were longer than 24 h. Large and medium sized arteries in lesions showed high density and there was slight occupying phenomenon. Gyri was asymmetric and part of the midline structures changed. The edges of lentiform nucleus were not clear and the density of brain gray matter decreased and brain white matter were without clear boundaries. Conclusion CT imaging findings in different stages are different. Clinicians should improve the recognition of the positive characteristics of CT imaging.

关 键 词：缺血性脑梗死 CT 影像学 发病时间 

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