应用CT脑CTP联合头颈CTA诊断缺血性脑卒中的临床价值  

Clinical Value of Brain CTP Combined with CTA of Head and Neck in the Diagnosis of Ischemic Stroke

作　　者：王思迅[1] 陆东[2] 李婕 宋春江[1] 刘梅[1] WANG Si-xun;LU Dong;LI Jie;SONG Chun-jiang;LIU Mei(Department of Neurology,Chengdu Sixth People's Hospital,Chengdu 610051,Sichuan Province,China;Department of Imaging,Chengdu Sixth People's Hospital,Chengdu 610051,Sichuan Province,China)

机构地区：[1]成都市第六人民医院神经内科,四川成都610051 [2]成都市第六人民医院影像科,四川成都610051

出　　处：《中国CT和MRI杂志》2022年第9期11-12,共2页Chinese Journal of CT and MRI

基　　金：成都市科技厅一般项目(2015-HM01-00294-SF)。

摘　　要：目的 分析CT脑CTP联合头颈CTA检查在缺血性脑卒诊断中的临床使用价值。方法 回顾性收集2020年1月至2020年4月在本院收治的18例确诊为缺血性脑卒中患者的临床资料。所有患者均进行脑CTP以及头颈部CTA检查。对患者所得图像进行分析,观察患者供血动脉狭窄、闭塞、斑块情况,对比患者健侧与患侧区域的脑灌注参数值。结果 18例患者均存在灌注异常的情况,其灌注异常区域CBV、 CBF值低于对侧正常区域,MTT则高于对侧正常区域,(P<0.05),但两者TTP比较差异无统计学意义(P>0.05);在本交18例患者中,检出有98处存在狭窄或者是闭塞的情况,其中以颈动脉交叉最多占23.47%,其次为大脑中动脉占19.38%、颈内动脉颅内段占17%。一共发现59个斑块,其中有31个(52.54%)为易损斑块。18例患者大脑动脉共有38处狭窄或者是闭塞的情况,其中多为大脑的中动脉病变, M1段可见有软斑块存在,患者的狭窄或者是闭塞出表现为充盈缺损现象。CTA检查共发现10例患者有侧枝循环现象,8例患者无侧枝循环情况。结论 对于缺血性卒中患者采取CTP和CTA联合检查从多角度对病情进行综合评价,可为临床诊断以及治疗方案选择提供参考依据。Objective To analyze the clinical value of brain CTP combined with CTA of head and neck in the diagnosis of ischemic stroke.Methods The clinical data of 18 patients diagnosed with ischemic stroke admitted in our hospital from January 2020 to April 2020 were retrospectively collected.All patients underwent brain CTP and CTA examinations of head and neck.The patient’s image was analyzed to observe the stenosis,occlusion,and plaque of the blood supply a rtery of the patient,and to compa re the parameter values of cerebral perfusion in the healthy side and the affected side of the patient.Results All 18 patients had abnormal perfusion.The CBV and CBF values in the abnormal perfusion area were lower than those in the contralateral normal area,and the MTT was higher than that in the contralateral normal area(P<0.05),but there was no statistically significant difference in TTP between them.(P>0.05).Among the 18 patients in this article,98 areas were found to have stenosis or occlusion,of which carotid artery fork accounted was the most common,accounting for 23.47%,followed by middle cerebral artery,accounting for 19.38% and intracra nial segment of internal ca rotid artery accounted for 17%.59 plaques in total were found,of which 31(52.54%) were vulnerable plaques.There were 38 stenosis or occlusions in the cerebral arteries of 18 patients.Most of them we re middle cerebral artery lesions.The re was soft plaque in M1 segment.The stenosis or occlusion of the patients showed filling defects.CTA examination found that 10 patients with collateral circulation,and 8 patients had no collateral circulation.Conclusion CTP combined with CTA examination can comprehensively evaluate the condition of patients with ischemic stroke from multiple angles,and provide a reference in choosing clinical diagnosis and treatment plan.

关 键 词：CTP CTA 缺血性脑卒中 临床价值 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R255.2[医药卫生—临床医学]