CT改良灌注技术在脑AVM立体定向放射外科靶区勾画中的价值  

The value of improved CT perfusion in delineation of brain AVM target for stereotactic radiosurgery

作　　者：江华 刘颖[1] 戴嘉中[2] 曹文静[2] 施惠东[2] 丁建[2] 汤旭群[3] 吴丽琼[2] 于同刚[2] 

机构地区：[1]上海理工大学医疗器械与食品学院,上海200093 [2]复旦大学附属华山医院上海伽玛医院放射科,上海200235 [3]复旦大学附属华山医院上海伽玛医院神经外科,上海200235

出　　处：《实用放射学杂志》2017年第11期1769-1772,共4页Journal of Practical Radiology

摘　　要：目的 探讨CT改良灌注技术在脑动静脉血管畸形（AVM）立体定向放射外科靶区勾画中的价值。方法 22例脑AVM患者均经数字减影血管造影（DSA）证实。14例患者以脑出血为临床首发症状（其中4例行急诊血肿清除术，术后3例行栓塞治疗；10例脑出血保守治疗患者中，3例行栓塞治疗），8例以癫痫或头痛为首发症状（均未行手术或栓塞治疗）。所有患者均在治疗前行CT改良灌注及磁共振血管成像（MRA）检查，以评价不同检查方法对脑血管畸形显示的诊断效能。结果 出血灶与肉芽组织对MRA图像的干扰率分别为27.3%与54.5%，对CT增强及CT改良灌注图像干扰率为0%；栓塞剂对CT增强及CT改良灌注图像干扰率为27.3%，对MRA图像干扰率为0%；MRA、CT及CT改良灌注的显著强化率分别为45.5%、54.5%及72.7%。结论 对于脑AVM并出血、手术患者，CT改良灌注技术有助于脑AVM立体定向放射外科靶区的显示。Objective To explore the value of improved CT perfusion in delineation of brain arteriovenous malformation（AVM） target for stereotactic radiosurgery.Methods 22 patients diagnosed with AVM by DSA were included in this study.14 cases of AVM were detected from initial symptoms of intracerebral hemorrhage, of which 4 cases were given immediate intracranial hematoma evacuation,then in 3 cases postoperative embolization was performed, and other 10 cases received conservative treatment including 3 cases treated by embolization. 8 cases of AVM were detected from initial symptoms of epilepsy or headache, without surgery or embolization treatment.In all patients,the improved CT perfusion and MRA examinations were performed before treatment to evaluate the diagnostic efficacy of different methods in AVM.Results The interference rates of hemorrhage and granulation tissue on MRA images were 27.3 % and 54.5 %, respectively, while those on enhanced CT and improved CT perfusion images were 0 %.The interference rate of embolization material on enhanced CT and improved CT perfusion images was 27.3 %, while that on MRA images were 0 %. The contrast-enhancement rates of MRA, CT and improved CT perfusion images were 45.5 %, 54.5 % and 72.7 %, respectively. Conclusion Improved CT perfusion technique is helpful in delineation of brain AVM target for stereotaetic radiosurgery in patients with AVM combined with intraeerebral hemorrhage or postoperative patients.

关 键 词：计算机体层成像 动静脉血管畸形 立体定向放射外科 

分 类 号：R814.42[医药卫生—影像医学与核医学] R743[医药卫生—放射医学]