低剂量CT颅脑灌注扫描在缺血性脑卒中的诊断价值  

Analysis of the application of low dose brain CT perfusion of patients with ischemic stroke

作　　者：王志刚[1,2] 伍兵 庄宇[1] 张箐[1] 杨燕 WANG Zhigang;WU Bin;ZHUAN Yu;ZHANG Jing;YANG Yan(Department of Radiology,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Radiology,Chengdu Shuangnan Hospital,Chengdu 610041,China)

机构地区：[1]四川大学华西医院放射科,四川成都610041 [2]成都双楠医院放射科,四川成都610041

出　　处：《西部医学》2018年第11期1662-1665,1671,共5页Medical Journal of West China

基　　金：四川省科技支撑计划项目(2014S20150)

摘　　要：目的探讨低剂量CT颅脑灌注在缺血性脑卒中的诊断价值。方法回顾性分析2015年9月~2016年7月四川大学华西医院急诊临床拟诊脑血管意外,行脑卒中CT扫描并以疑似脑梗塞住院治疗的218例患者的影像资料,以中华医学会神经病学分会脑血管病学组发布的《中国急性缺血性脑卒中诊治指南2014》为标准,探讨低剂量颅脑CT灌注扫描的临床价值,分析缺血性脑卒中患者患侧及对侧的CTP主要参数情况(CBF、CBV、MTT及TTP)以及缺血性脑卒中患者半暗带及对侧的CTP主要参数情况(CBF、CBV、MTT及TTP)。结果 (1)低剂量CT灌注的灵敏度为87.3%,特异性为75.6%(P>0.05),其中MTT最敏感。(2)对影像诊断为急性缺血梗塞灶的CTP参数(CBF、CBV、MTT及TTP)与对照区参数比较,差异有统计学意义(P<0.05)。(3)对影像诊断为急性缺血梗塞,同时伴有缺血半暗带的CTP参数CBF、CBV、MTT及TTP参数与对照区参数比较,CBF、MTT及TTP差异有统计学意义(P<0.05)。结论以临床为标准,低剂量CT颅脑灌注扫描具有较高的实用性,能够给临床医生带来有效的证据。Objective To discuss the application of low-dose brain CT perfusion imaging of patients with ischemic strokes.Methods The brain CT perfusion imaging and the clinical data of 218 patients were analyzed,which were diagnosed clinically as acute ischemic stroke in the emergency department of West China Hospital of Sichuan University from Sep.2015 to Jul.2016.The clinical diagnostic value was discussed based on the Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke in China 2014.The ipsilateral and contralateral CTP parameters of patients with ischemic cerebral apoplexy were analyzed including CBF,CBV,MTT and TTP.The semi-dark band and contralateral CTP parameters were also analyzed.Results The sensitivity and specificity of low dose CT perfusion imaging were 87.3%and 75.6%respectively(P>0.05),and MTT was the most sensitivity.There were statistically differences of the ipsilateral and contralateral CTP parameters of patients with ischemic cerebral apoplexy including CBF,CBV,MTT and TTP(P<0.05).There were statistically differences of the semi-dark band and contralateral CTP parameters of patients with ischemic cerebral apoplexy including CBF,MTT and TTP(P<0.05).Conclusion Low dose brain CT perfusion imaging could have higher diagnostic value based on clinical criterion,and could provide reliable evidence for doctors.

关 键 词：辐射剂量 体层摄影术 X线计算机 灌注成像 缺血性脑血管病 急性脑卒中 

分 类 号：R743.34[医药卫生—神经病学与精神病学]