脑梗死前期脑局部低灌注的CT灌注成像表现及分期  

CT perfusion imaging and stages of regional cerebral hypoperfusion in pre-infarction period

作　　者：高培毅[1] 林燕[1] 

机构地区：[1]北京市神经外科研究所神经影像中心,100050

出　　处：《中华放射学杂志》2003年第10期882-886,共5页Chinese Journal of Radiology

基　　金：国家自然科学基金资助项目 (3 0 0 70 2 3 4);北京市自然科学基金资助项目 (70 0 2 0 11);北京市自然科学基金资助项目 (70 3 2 0 0 9)

摘　　要：目的　探讨脑梗死前期动态CT灌注成像分期的应用价值。方法　对 32例临床诊断为脑局部缺血患者作了CT灌注成像和局部脑血流量 (regionalcerebralbloodflow ,rCBF)、局部脑血容量 (regionalcerebralbloodvolume ,rCBV)、平均通过时间 (meantransittime ,MTT)和最大峰值时间(time to peak ,TTP)比值 (病侧 /健侧 )测量。根据影像学表现进行脑梗死前期的分期 ,包括Ⅰ1期 :TTP延长 ,MTT、rCBF和rCBV正常 ;Ⅰ2 期 :TTP和MTT延长 ,rCBF正常 ,rCBV正常或轻度升高 ;Ⅱ1期 :TTP、MTT延长以及rCBF下降 ,rCBV基本正常或轻度下降 ;Ⅱ2 期 :TTP、MTT延长 ,rCBF和rCBV下降。结果　Ⅰ1期 4例 ,CT灌注成像见脑局部TTP延长 ,MTT、rCBF和rCBV正常。rCBF、rCBV、MTT和TTP平均比值分别为 1 0 0、1 0 0、1 0 0和 1 30。Ⅰ2 期 13例 ,表现为脑局部TTP和MTT延长 ,rCBF和rCBV正常 (8/ 13)或rCBV轻度增高 (5 / 13)。rCBF、rCBV、MTT和TTP平均比值分别为 1 0 0、1 0 3、1 38和 1 30。Ⅱ1期 8例 ,CT灌注成像见TTP、MTT延长以及rCBF下降 ,rCBV正常 (3/ 8)或轻度下降 (5 / 8)。rCBF、rCBV、MTT和TTP平均比值分别为 0 5 6、0 94、1 4 9和 1 4 7。Ⅱ2 期 4例 ,表现为脑局部区域TTP、MTT延长 ,rCBF和rCBV下降。rCBF、rCBV、MTT和TTP平?Objective To investigate the applicative value in stages of pre-infarction period using dynamic perfusion CT. Methods Dynamic perfusion CT was performed in 32 cases of cerebral hypoperfusion. The ratios of side-to-side were measured at hypoperfusion areas in the regional cerebral ischemia. The stages of pre-infarction period were made as the following: (Ⅰ 1) TTP was delayed, MTT, rCBF and rCBV were normal; (Ⅰ 2) TTP and MTT were delayed, rCBF was normal, and rCBV was normal or slightly increased; (Ⅱ 1) TTP and MTT were delayed, rCBF was decreased, and rCBV was normal or slightly decreased; (Ⅱ 2) TTP and MTT were delayed, rCBF and rCBV were decreased. Results There were 4 cases in stage Ⅰ 1. Regional hypoperfusion was revealed only by TTP map. The mean ratios of rCBF, rCBV, MTT, and TTP were 1.00, 1.00, 1.00, and 1.30, respectively. In stage Ⅰ 2, the areas of delayed TTP and MTT were found in all 13 cases. The rCBF and rCBV maps appeared normal in 8 cases. Another 5 cases showed normal rCBF and slightly increased rCBV areas. The mean ratios of rCBF, rCBV, MTT, and TTP were 1.00, 1.03, 1.38, and 1.30, respectively. In stage Ⅱ 1, the areas of delayed TTP and MTT were revealed in all 8 cases. The depiction of decreased rCBF was also found in 8 cases. The areas of decreased rCBV were showed in 5 cases, and normal rCBV maps were revealed in 3. The mean ratios of rCBF, rCBV, MTT, and TTP were 0.56, 0.94, 1.49, and 1.47, respectively. In stage Ⅱ 2, the areas of delayed TTP and MTT were revealed in all 4 cases, in whom depiction of decreased rCBF and rCBV was also found. The mean ratios of rCBF, rCBV, MTT, and TTP were 0.42, 0.59, 1.57, and 1.55, respectively. Conclusion CT perfusion imaging and its parameters' analysis may play an increasing role to delineate the depiction of cerebral hypoperfusion in pre-infarction period. Analyzing the relationship of rCBF, rCBV, MTT, and TTP is very helpful to know the status of the capillary vessels in regional cerebral hypoperfusion area and to provide

关 键 词：脑梗死 脑局部低灌注 CT灌注成像 分期 梗死前期 脑局部缺血 

分 类 号：R816.1[医药卫生—放射医学]