醒后卒中与时间窗明确卒中多模态CT表现  

Multimodality CT characteristics of wake-up stroke and onset clear stroke

作　　者：於帆 Arman Sha 单艺[1,2] 郭道德 张苗[1,2] 马青峰 卢洁[1,2] YU Fan;Arman Sha;SHAN Yi;GUO Daode;ZHANG Miao;MA Qingfeng;LU Jie(Department of Radiology and Nuclear medicine,,Capital Medical University,Beijing 100053,China;Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics,Beijing 100053,China;Department of Neurology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院放射与核医学科,北京100053 [2]磁共振成像脑信息学北京市重点实验室,北京100053 [3]首都医科大学宣武医院神经内科,北京100053

出　　处：《中国医学影像技术》2022年第12期1769-1773,共5页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(82130058);北京市自然科学基金(Z190014)。

摘　　要：目的对比观察醒后卒中(WUS)与时间窗明确卒中(OCS)患者的多模态CT表现。方法纳入因急性缺血性卒中而接受多模态CT检查的36例WUS患者(WUS组)与41例OCS患者(OCS组,起病时间<6 h),均经头颈部CT血管造影证实存在前循环大血管闭塞。采用Alberta卒中项目早期CT评分(ASPECTS)评价平扫CT所示早期脑缺血改变。将CT灌注(CTP)存在脑血流量(CBF)与脑血容量(CBV)不匹配区域认定为缺血半暗带,采用ASPECTS评价异常灌注范围(CBF-ASPECTS、CBV-ASPECTS)。结果WUS组与OCS组平扫CT中位ASPECTS均为8.0分,差异无统计学意义(P>0.05)。27例(27/36,75.00%)WUS患者、30例(30/41,73.17%)OCS患者CTP存在缺血半暗带。WUS组与OCS组中位CBF-ASPECTS分别为3.0分及2.0分,CBV-ASPECTS均为6.0分,差异均无统计学意义(P均>0.05)。结论WUS与起病6 h内OCS的多模态CT表现相似。Objective To comparatively analyze multimodality CT characteristics of patients with wake-up stroke(WUS)or onset clear stroke(OCS).Methods Totally 36 WUS patients(WUS group)and 41 OCS patients(OCS group,onset time<6 h)with occlusion of large vessels in the anterior circulation confirmed by head and neck CT angiography and underwent multimodal CT examination due to acute ischemic stroke were enrolled.Alberta stroke program early CT score(ASPECTS)was used to evaluate early cerebral ischemic changes shown on plain CT.The mismatch between cerebral blood flow(CBF)and cerebral blood volume(CBV)on CTP was recognized as penumbra.Abnormal perfusion ranges(CBF-ASPECTS,CBV-ASPECTS)were evaluated with ASPECTS.Results The median ASPECTS on plain CT of WUS group and OCS group were both 8.0(P>0.05).Ischemic penumbra was found in 27(27/36,75.00%)WUS patients and 30(30/41,73.17%)OCS patients.The median CBF-ASPECSTS was 3.0 in WUS group and 2.0 in OCS group,respectively,while CBV-ASPECTS were both 6.0 in 2 groups.There was no significant difference of median CBF-ASPECSTS nor CBV-ASPECTS between groups(both P>0.05).Conclusion Multimodal CT characteristics of WUS were similar to those of OCS within 6 h of onset.

关 键 词：卒中 体层摄影术 X线计算机 灌注成像 血管造影术 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R814.42[医药卫生—临床医学] R816.2