胸部CT左室测量评估急性缺血性卒中患者整体脑血流灌注水平的初步研究  

Preliminary study on the correlation between left ventricular size on CT and cerebral blood flow perfusion in patients with acute ischemic stroke

作　　者：暴捷 张怡梦 王艳[1] 杜祥颖[1] 卢洁[1] BAO Jie;ZHANG Yi-meng;WANG Yan;DU Xiang-ying;LU Jie(Department of Radiology,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科,北京100053

出　　处：《中国临床医学影像杂志》2023年第2期77-81,共5页Journal of China Clinic Medical Imaging

摘　　要：目的:应用胸部CT图像进行左心室大小测量并分析其与急性缺血性卒中大脑整体血流灌注的相关性,初步探讨左室测量作为急性缺血性卒中患者整体脑血流灌注水平评估因子的可行性。资料与方法:回顾性纳入127例急性缺血性脑卒中并行多模态CT检查的患者,应用急诊筛查胸部CT多平面重组图像测量左室短轴最大横径,同时在脑CT灌注图像中勾画感兴趣区,测量健侧大脑各区脑血流量及脑血容量,分析左心室短轴横径与各区脑血流量及脑血容量的相关性。结果:伴有左心室扩大的卒中患者相较于无左心室扩大的患者,健侧额叶、颞叶、枕叶、尾状核头、丘脑、壳核以及半球平均脑血流量均有减低(P<0.05),其中额叶、颞叶、枕叶脑血流量差异最为显著;各脑叶平均脑血容量在男性患者中两组差异同样具有统计学差异。此外,在伴有左心室扩大的患者中,左心室短轴横径与各区脑血流量均呈负相关。结论:利用胸部CT图像测量左心室大小可以对左心室功能状态进行初步判断,所测结果与整体脑血流灌注存在相关性,可以做为急诊中缺血性卒中患者整体脑血流灌注水平的评估手段。Objective: To evaluate the correlation between left ventricular function and global cerebral blood perfusion in patients with acute ischemic stroke by measuring the left ventricle with chest CT images. Materials and Methods: 127 patients with acute ischemic stroke confirmed by multimodal CT examination were retrospectively analyzed. The patients ’ chest CT images were used for multiplanar reconstruction. The maximum transverse diameter of the short axis of the left ventricle was measured, and then the region of interest was delineated in the CT perfusion images, so as to establish the correlation with the regional cerebral blood perfusion and the basis for further evaluating the value of cardiac structure and function as-sessment in the prognosis of patients with ischemic stroke. Results: Compared with patients without left ventricular enlargement, the average cerebral blood flow of the frontal lobe, temporal lobe, occipital lobe, head of caudate nucleus, thalamus,putamen and hemisphere in stroke patients with left ventricular enlargement were decreased(P <0.05), and the difference in cerebral blood flow of the frontal lobe, temporal lobe and occipital lobe was the most significant. The average cerebral blood volume of each lobe in male patients was also statistically different between the two groups. In patients with left ventricular enlargement, the short axis diameter of the left ventricle was negatively correlated with regional cerebral blood flow. Conclusion: Using chest CT images to measure the left ventricular size can preliminarily assess left ventricular function, and the results correlated with the global cerebral blood perfusion, which can provide a reference for the comprehensive evaluation of patients with acute ischemic stroke.

关 键 词：缺血性卒中 心室功能 左 体层摄影术 X线计算机 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R322.11[医药卫生—临床医学] R814.42