CT灌注成像联合头颈CTA对急性脑梗死的诊断价值  

Diagnosis valuble of CT perfusion imaging combined with CTA for acute ischemic stroke

作　　者：吴菊芳[1] 梁立华[1] 陈志军[1] 梁韬[1] 冯晓荣[1] 

机构地区：[1]深圳市福田区人民医院影像科,广东深圳518003

出　　处：《中国现代医生》2016年第12期108-111,F0003,共5页China Modern Doctor

基　　金：广东省深圳市福田区卫生公益性科研项目(FTWS201330)

摘　　要：目的探讨脑CT灌注(CTP)成像联合头颈CT血管成像(CT angiography,CTA)对急性缺血性脑卒中的诊断价值,为临床诊断、及时处理脑卒中患者提供可靠的依据。方法收集神经内科诊治急性脑梗死患者30例,所有患者均已完成64层CT平扫和CTA、CTP检查。30 d后复查头颅CT或MRI平扫。结果与对侧正常对照区相比,脑梗死区及缺血半暗带区CBF明显降低,MTT显著增加(P<0.05);脑梗死区CBV及CBF明显低于缺血半暗带区,MTT显著长于缺血半暗带区(P<0.05);CTA共显示14例患者存在脑动脉局限性狭窄。结论 CTP能够快速直观区分梗死区与半暗带区,对于较大的闭塞血管,CTA能找到梗死责任血管,为不能溶栓的患者介入治疗提供影像学依据。Objective To investigate the value of cerebral CT perfusion（CTP） imaging combined with CTA in the diagnosis of acute ischemic stroke,and to provide a reliable basis for clinical diagnosis and timely treatment of stroke patients.Methods Neurological department of internal medicine in the diagnosis and treatment of acute cerebral infarction in 30 cases,all patients had completed the 64-slice spiral CT scan,CTA,CTP examination.30 days later,the head CT or MRI scans were reviewed.Results Compared with the contralateral normal region,cerebral infarction and ischemia penumbra CBF decreased significantly,MTT was significantly increased（P〈0.05）;cerebral infarction area of CBV and CBF was lower than that in ischemia penumbra.MTT was significantly longer than that in the ischemic penumbra（P〈0.05）;CTA showed limitations of cerebral artery stenosis of 14 patients.Conclusion CTP can quickly and visually distinguish between infarct area and ischemic penumbra,for the larger occluded vessels,CTA can find the infarction responsible blood vessels,which can provide imaging evidence for patients who can not be treated with thrombolysis.

关 键 词：脑梗死 急性期 脑灌注 体层摄影术 X线计算机 

分 类 号：R743.31[医药卫生—神经病学与精神病学] R816.1[医药卫生—临床医学]