脑灌注成像技术联合CT血管造影对缺血性脑卒中患者的诊断及治疗计划制定的意义  

Analysis of the significance of cerebral perfusion imaging combined with CT angiography in the diagnosis and treatment plan of patients with ischemic stroke

作　　者：符惠宏 张雪红[1] 李旻[1] 黄勇[1] Fu Huihong;Zhang Xuehong;Li Min;Huang Yong(Department of Radiology,Taizhou First People′s Hospital,Zhejiang Taizhou 318020,China)

机构地区：[1]浙江省台州市第一人民医院放射科,318020

出　　处：《中国医师进修杂志》2019年第12期1103-1107,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨脑灌注成像技术联合CT血管造影(CTA)对缺血性脑卒中患者的诊断及治疗计划制定的意义。方法选取2018年1—9月浙江省台州市第一人民医院收治的急性脑梗死患者44例。在患者发病的12 h内同时给予脑灌注成像及CTA检查,将灌注成像的结果使用图像工作站处理,测量患者颅脑内缺血区域的相关灌注参数水平;通过CTA对患者的头颅、颈部进行血管造影;以所有患者的脑血管造影结果为金标准。观察比较不同检查方式对缺血性脑卒中患者的临床诊断情况、诊断效能及不同的灌注异常区域与正常对照区域之间在灌注成像各个参数水平方面的差异。结果根据患者的脑血管造影及单光子发射计算机断层成像(SPECT)检查情况作为对比金标准,灌注成像各个参数当中,脑组织血流量(CBF)与造影剂的平均通过时间(MTT)的准确率最高;灌注成像+CTA临床确诊结果的准确率为93.2%,特异度为100.0%,灵敏度为90.1%,显著高于单项诊断方式的临床效能(P<0.05)。结论灌注成像联合CTA可以为缺血性脑卒中患者的临床诊疗提供重要的辅助参考信息。Objective To investigate the significance of cerebral perfusion imaging combined with CT angiography(CTA)in the diagnosis and treatment plan of patients with ischemic stroke.Methods Total of 44 patients with acute cerebral infarction were enrolled in Taizhou First People′s Hospital from January 2018 to September 2018.Cerebral perfusion imaging and CTA examination were performed simultaneously within 12 h after the onset of the disease.The images of perfusion imaging were processed using an image workstation to measure the level of perfusion parameters in the ischemic region of the patient′s brain.The head and neck of the patient were measured by CTA.The angiography was performed,and the cerebral angiography results of all patients were as the gold standard.The clinical diagnosis and diagnostic efficacy of different examination methods in patients with ischemic stroke was observed and compared,and the differences in the parameters of perfusion imaging between different perfusion abnormal areas and normal control areas were compared.Results When patients′cerebral angiography and single-photon emission computed tomography(SPECT)was as the gold standard for comparison,cerebral blood flow(CBF)and mean transit time(MTT)had the highest accuracy among all parameters of perfusion imaging.The accuracy rate of perfusion imaging+CTA was 93.2%,with a specificity of 100.0%and a sensitivity of 90.1%,which was significantly higher than that of the clinical efficacy of single diagnosis.Conclusions Perfusion imaging combined with CTA can provide important supplementary reference information for clinical diagnosis and treatment of patients with ischemic stroke.

关 键 词：脑灌注成像 CT血管造影 缺血性脑卒中 诊断效能 

分 类 号：R74[医药卫生—神经病学与精神病学]