CT脑灌注成像对脑梗死患者溶栓治疗前后脑血流动力学改变的评价  

Evaluation of Cerebral Hemodynamic Changes in Patients with Cerebral Infarction before and after Thrombolytic Therapy by CT Perfusion Imaging

作　　者：马宇[1] MA Yu(Medical Imaging Department,Cangzhou Hospital of Integrated TCM-WM·Hebei,Hebei 061000,China)

机构地区：[1]河北省沧州中西医结合医院医学影像科,河北061000

出　　处：《影像技术》2023年第2期4-7,17,共5页Image Technology

基　　金：河北省中医药管理局课题(2022227)。

摘　　要：目的:探讨分析CT脑灌注成像对脑梗死患者溶栓治疗前后脑血流动力学改变的评价。方法:抽选院内收治疑似脑梗死患者80例,时间为2020年1月-2022年1月,患者均以临床治疗结果为金标准,并接受CT脑灌注成像检查,探讨其诊断价值,同时对入院后确诊脑梗死患者静脉溶栓治疗前后脑血流动力学指标进行对比与分析。结果:CT脑灌注成像诊断特异性90.00%(18/20)、灵敏性96.67%(58/60),与临床结果一致性较高(Kappa=0.765);梗死区域脑血容量、脑血流量低于健康区域(P<0.05),且峰值时间高于健康区域(P<0.05);60例患者溶栓后缺血边缘区脑血流量高于溶栓前(P<0.05);60例患者溶栓前后缺血中心区脑血流量、血容量对比无统计学差异(P>0.05)。结论:在脑梗死患者的临床诊断中,CT脑灌注成像诊断价值较高,可准确观察溶栓前后脑血流动力学的变化,可为后续治疗提供准确和有力的支持,临床价值明确。Objective:To evaluate the changes of cerebral hemodynamics in patients with cerebral infarction before and after thrombolytic therapy by CT perfusion imaging.Methods:In this study,80 patients with suspected cerebral infarction were selected and treated in the hospital.From January 2020 to January 2022,all patients took the clinical treatment results as the gold standard,and received CT cerebral perfusion imaging to explore its diagnostic value.At the same time,the cerebral hemodynamic indexes of patients with cerebral infarction diagnosed after admission before and after intravenous thrombolytic therapy were compared and analyzed.Results:The specificity of CT cerebral perfusion imaging was 90.00%(18/20),and the sensitivity was 96.67%(58/60),which was consistent with the clinical results(Kappa=0.765);the cerebral blood volume and cerebral blood flow in the infarcted area were lower than those in the healthy area(P<0.05);the peak time was higher than that in healthy area(P<0.05);The cerebral blood flow of ischemic border area in 60 patients after thrombolysis was higher than that before thrombolysis(P<0.05);there was no significant difference in cerebral blood flow and blood volume of ischemic central area in 60 patients before and after thrombolysis(P>0.05).Conclusion:In the clinical diagnosis of patients with cerebral infarction,CT cerebral perfusion imaging is of high diagnostic value.It can accurately observe the changes of cerebral hemodynamics before and after thrombolysis,and provide accurate and powerful support for the follow-up treatment.The clinical value is clear.

关 键 词：脑梗死 CT脑灌注成像 静脉溶栓 诊断价值 脑血流动力学 

分 类 号：R445.4[医药卫生—影像医学与核医学] R816.1[医药卫生—诊断学]