256层CT脑CTP联合头颈CTA对缺血性脑卒中早期诊断的临床应用研究  

Clinical Application of 256-slice CT brain CTP Combined with Head and Neck CTA in Early Diagnosis of Ischemic Stroke

作　　者：李韬略 谢会明 Li Taolue;Xie Huiming(Department of Medical Imaging,Yueyang Hospital of Traditional Chinese Medicine,Yueyang,Hunan 414000)

机构地区：[1]岳阳市中医医院医学影像科,湖南岳阳414000

出　　处：《现代医用影像学》2024年第6期1006-1010,共5页Modern Medical Imageology

摘　　要：目的:观察256层CT脑CTP联合头颈CTA对缺血性脑卒中早期诊断的临床应用研究分析。方法:将回顾性分析岳阳市中医医院于2022年3月至2024年2月收治临床诊断为早期缺血性脑卒中的患者62例,以为本次研究对象,将其就诊时接受256层CT脑CTP、头颈CTA检查结果分析,明确联合应用对早期诊断的指导意义。结果:在梗死区域,CBV和CBF与对侧对应区域,统计学差异显著(P<0.01),而在半暗带区域,TTP和CBF与对侧对应区域的统计学差异显著(P<0.01),而CBV之间的差异并不具有统计学意义(P<0.05)。62例患者中,共有157个动脉斑块被检测出存在于椎动脉、基底动脉和颈动脉,CTP异常同侧动脉狭窄程度(轻度、中度、重度及闭塞率)均高于CTP异常对侧,差异有统计学意义(P<0.05)。CTP与CTA联合诊断的敏感性高于单一检测。结论:早期诊断缺血性脑卒中,256层CT脑CTP与头颈CTA联合应用能提高诊断效能,可为临床治疗方案提供可靠的参考依据,值得推广。Objective:To observe the clinical application of 256-slice CT brain CTP combined with head and neck CTA in the early diagnosis of ischemic stroke.Methods:62 patients with early ischemic stroke diagnosed clinically in our hospital from March 2022 to February 2024 were retrospectively analyzed.The results of 256 slice CT brain CTP and head and neck CTA were analyzed to clarify the guiding significance of combined application for early diagnosis.Results:In the infarcted region,CBV and CBF were significantly different from those in the contralateral corresponding region(P<0.01),while in the penumbra,TTP and CBF were significantly different from those in the contralateral corresponding region(P<0.01),while the difference between CBV was not statistically significant(P<0.05).Among the 62 patients,there were 934 cases of artery or site,and 319 cases of stenosis or occlusion were detected,including 67 cases of carotid bifurcation(21.00%),61 cases of middle cerebral artery(19.12%)and 54 cases of intracranial segment of internal carotid artery(16.92%).A total of 157 arterial plaques were detected in vertebral artery,basilar artery and carotid artery studies.There were 67 mixed plaques,59 calcified plaques,27 fibrous plaques and 14 fat plaques.63 plaques met the vulnerability criteria,accounting for 40.13%of the total.CTA examination showed that stenosis or occlusion of the cerebral artery mainly concentrated in the middle cerebral artery,soft plaque was found in Ml segment,and flling defect or occlusion was found in the rest of the cerebral artery.Conclusion:The combination of 256 slice CT brain CTP and head and neck CTA is of great value in the early diagnosis of ischemic stroke.

关 键 词：256层CT 脑CTP 头颈CTA 联合检查 缺血性脑卒中 早期诊断 

分 类 号：R816.1[医药卫生—放射医学] R743.3[医药卫生—临床医学]