一站式CTA联合CTP扫描在急性脑梗死患者临床诊断中的应用价值分析  

Application Value of One-stop CTA Combined with CTP Scan in the Clinical Diagnosis of Patients with Acute Cerebral Infarction

作　　者：饶德利[1] 邱晓明[1] 朱燕莉[2] RAO De-li;QIU Xiao-ming;ZHU Yan-li(Radiology Department,Huangshi Central Hospital(Affiliated Hospital of Hubei Polytechnic University),Huangshi 435000,Hubei Province,China;Outpatient Department,Huangshi Central Hospital(Affiliated Hospital of Hubei Polytechnic University),Huangshi 435000,Hubei Province,China)

机构地区：[1]黄石市中心医院(湖北理工学院附属医院)放射影像科,湖北黄石435000 [2]黄石市中心医院(湖北理工学院附属医院)门诊,湖北黄石435000

出　　处：《中国CT和MRI杂志》2024年第6期16-18,共3页Chinese Journal of CT and MRI

基　　金：湖北省卫生健康委员会科研项目(WJ2019M043)。

摘　　要：目的 探讨一站式CT血管成像(CTA)联合CT灌注成像(CTP)扫描在急性脑梗死患者临床诊断中的应用价值。方法 选取2020年8月~2021年8月期间医院收治的急性脑梗死患者63例,均进行一站式CTA联合CTP扫描检查,分析患者梗死区、缺血半暗带区以及相应对侧区CTP检查参数,并分析患者血管狭窄程度与灌注异常以及侧支循环形成的关系。结果63例急性脑梗死患者CTP检查均发现脑血流灌注异常,梗死区患侧CBF、 CBV低于对侧区(P<0.05),TTP较对侧区无限延迟;缺血半暗带区患侧CBF低于对侧区(P<0.05),TTP高于对侧区(P<0.05),CBV与对侧区无显著差异(P>0.05)。63例急性脑梗死患者中,轻度、中度、重度狭窄以及闭塞患者分别为31例、24例、6例和2例,其中22例侧支循环形成,且有梗死区、缺血半暗带区以及侧支循环形成的患者比例伴随血管狭窄程度的加剧而逐渐增多(P<0.05)。结论 CTP检查能够快速、准确地区分梗死区与缺血半暗带区,CTA可对供血动脉狭窄程度及闭塞情况进行评估,一站式CTA联合CTP扫描在急性脑梗死患者临床诊断中具有重要的指导价值。Objective To explore the application value of one-stop computed tomography angiography(CTA)combined with computed tomography perfusion(CTP) in the clinical diagnosis of patients with acute cerebral infarction.Methods 63 patients with acute cerebral infarction who were treated in the hospital were selected between August 2020 and August 2021,and they underwent one-stop CTA combined with CTP scan.The CTP parameter in the infarct area,ischemic penumbra area and corresponding contralateral areas were analyzed among the patients,and the relationship between vascular stenosis degree and abnormal perfusion and collateral circulation formation was analyzed.Results CTP examination of 63 patients with acute cerebral infarction showed abnormal cerebral blood perfusion.The CBF and CBV of the affected side in the infarct area were lower than those of the contralateral area(P<0.05),and the TTP was infinitely delayed compared to the contralateral area.The CBF of the affected side in ischemic penumbra area was lower than that in the contralateral area(P<0.05),and the TTP was longer than that in the contralateral area(P<0.05),but there was no significant difference in CBV compared to the contralateral a rea(P>0.05).Among 63 patients with acute cerebral infa rction,there were 31 cases of mild stenosis,24 cases of moderate stenosis,6 cases of severe stenosis and 2 cases of occlusion respectively,including 22 cases of collateral circulation formed.With the aggravation of vascular stenosis degree,the proportions of patients with infarct area,ischemic penumbra area and collateral circulation were gradually increased(P<0.05).Condusion CTP examination can quickly and accurately distinguish the infarct area and ischemic penumbra area,and CTA can evaluate the stenosis and occlusion of supplying artery.One-stop CTA combined with CTP scan has important guiding value in the clinical diagnosis of patients with acute cerebral infarction.

关 键 词：CT血管成像 CT灌注成像 急性脑梗死 诊断 

分 类 号：R44[医药卫生—诊断学]