脑CT灌注图像匹配技术在缺血性卒中的应用研究  

The research of CT perfusion image matching technology in ischemic stroke

作　　者：丁里[1] 王玉玲 符浩[1] 张蕾[1] 杨淑[1] 朱会敏[1] 马娟[1] 

机构地区：[1]云南省第一人民医院神经内科,云南昆明650032 [2]信阳市中心医院神经内科,河南信阳464000

出　　处：《转化医学杂志》2016年第3期149-154,170,共7页Translational Medicine Journal

基　　金：云南省卫生科技计划项目(2012WS0069)

摘　　要：目的探讨CT灌注参数图像标准化匹配技术对梗死后脑组织的缺血状态及确定客观半暗带的评估作用。方法对缺血性卒中患者40例行常规CT灌注检查,重建数据后根据脑血容量(cerebral blood volume,CBV)、脑血流量(cerebral blood flow,CBF)、达峰时间(time to peak,TTP)参数分别确定彻底坏死区(non variable tissue,NVT)、严重缺血区(tissue at risk,TAR)、相对缺血区(relative ischemic tissue,RIT)阈值及在脑组织的绝对面积大小,并将3个区域CBF、CBV、TTP参数进行图像匹配,对匹配结果进行分析。结果坏死边缘、严重缺血区、相对缺血区边缘阈值分别为CBV=1.7 m L/100 g、CBF=30.0 m L/(100 g·min)、TTP=9.5 s。图像匹配后可清楚分辨出急性期缺血区的坏死区以及严重缺血区、相对缺血区构成的缺血半暗带并可进行量化面积。匹配后复合性单病灶常见RIT>NVT>TAR、NVT>TAR>RIT,皮质下单病灶组RIT>NVT>TAR或NVT>RIT>TAR,多发梗死病灶组RIT>NVT>TAR、NVT>TAR>RIT。结论利用图像标准化匹配方法可以通过CBV、CBF、TTP参数量化评估病灶的NVT、TAR和RIT区域,直观显示缺血半暗带面积,为临床治疗缺血性卒中提供个体化影像评估技术。Objective To evaluate the post-stroke penumbral areas using CT perfusion image matching technology. Methods Forty patients with ischemic stroke were completed the CTP exami-nation. Non variable tissue ( NVT) ,tissue at risk ( TAR) and relative ischemic tissue ( RIT) were matched and compared using cerebral blood volume ( CBV) , cerebral blood flow ( CBF) and time to peak (TTP). Results The threshold value of CBV, CBF and TTP is 1.7 mL/100 g, 30. 0 mL/(100 g?min) and 9.5 s respectively. For compound single infarction group, one case was saw in the type of RIT>NVT>TAR. For subcortical single infarction group, there are one case of RIT>NVT>TAR and four cases of the type RIT>TAR>NVT and one case of the NVT>RIT>TAR. For multiple infarc-tions group, the type of RIT>NVT>TAR has 16 cases and RIT>TAR>NVT has 10 cases and one case with the type of NVT>TAR>RIT. Conclusion CT perfusion image matching technology can confirm the different area of NVT, TAR, RIT accurately and quickly. The penumbralarea can be ob-served apparently. This technique can be used for clinical treatment of ischemic stroke as individual image assessment technology.

关 键 词：缺血性卒中 脑CT灌注 图像匹配 缺血半暗带 

分 类 号：R743.3[医药卫生—神经病学与精神病学]