急诊CT灌注成像早期识别卒中样癫痫发作的研究进展  

Progress of CT perfusion in early diagnosis of stroke-like epileptic seizures

作　　者：陆叶婷 胡小伟[1] Lu Yeting;Hu Xiaowei(Department of Neurology,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院神经内科,215006

出　　处：《中华神经科杂志》2020年第11期963-968,共6页Chinese Journal of Neurology

基　　金：苏州市科技计划项目(SLT201908);江苏省青年医学重点人才项目(QNRC2016731)。

摘　　要：癫痫发作(包括发作后状态)约占卒中模拟病的38%,易与急性缺血性脑血管事件相混淆,脑电图作为最重要的辅助检查,阳性率低、不具备急诊条件,在早期识别癫痫发作中的应用有限。在急诊背景下,CT灌注成像经济、检查时间短,已广泛用于早期筛选和评估卒中人群。而癫痫发作亦伴随灌注改变,并具有一定的特征性,利用不同时期的灌注模式尤其是局部高灌注可在早期将卒中样癫痫发作与脑血管病进行鉴别,明确诊断并做出合理临床决策,从而改善患者预后。Seizures(including postictal state)account for about 38%of stroke mimics,which are easily confused with acute ischemic cerebrovascular events.Electroencephalogram,with a low interictal positive rate,has limitations in early diagnosis of epileptic seizures because it is usually unavailable in the emergency room.In acute settings,CT perfusion imaging is economical and has a short examination time.It is widely used for early screening and evaluation of suspected stroke.Seizures are accompanied by perfusion changes and have certain characteristics.CT perfusion patterns in different periods,especially for focal hyperperfusion,can distinguish stroke-like seizures from cerebrovascular events at an early stage.It helps to make a clear diagnosis and appropriate clinical decisions,leading to improve patients′prognosis.

关 键 词：灌注成像 卒中 鉴别诊断 癫痫 

分 类 号：R742.1[医药卫生—神经病学与精神病学]