平板CT脑血容量检测在急性缺血性脑卒中处理中的应用

目的为观察急性脑梗死病人血管再通前后脑血容量变化,探讨平板CT（FDCT）脑血容量检测的临床应用价值。方法前瞻性分析9例急性脑梗死病人的临床资料,其中颈内动脉闭塞3例,大脑中动脉闭塞6例;术前病人TIC1分级均为0级。均采用机械血管再通技术治疗,术前及术后即刻完成FDCT脑血容量检测,比较急性脑梗死病人双侧半球脑血容量变化及手术对其影响。结果术后TICl分级2级4例,3级5例。术前病侧脑血容量明显低于健侧（P〈0．001）,血管再通术后病侧脑血容量明显升高（P=0．002）,术后双侧半球脑血容量无明显差异（P=0．376）。结论FDCT脑血容量检测可在急性缺血性卒中超早期显示病侧脑血容量明显下降,且该方法可在导管室内完成,缩短检查时间,有助于为治疗决策提供帮助。

Application of flat-panel detector CT for detecting cerebral blood volume in management of acute ischemic stroke

Objective To observe the change of cerebral blood volume （CBV） after recanalization in patients with acute cerebral infarction and explore the clinical application of fiat-panel detector CT （FDCT） for CBV. Methods Clinical data of 9 patients with acute cerebral infarction were analyzed prospectively, including internal carotid artery occlusion in 3 patients and middle cerebral artery occlusion in 6. Preoperative TICI classification showed 0 grade and mechanical recanalization were performed in all the patients. FDCT for CBV was performed before and immediately after treatment. The bilateral CBV changes and the surgical effects were compared. Results Postoperative TICI classification showed grade 2 in 4 patients and grade 3 in 5. Preoperative CBV of the injured side was significantly lower than that of the uninjured side （P 〈 0.001） and it dramatically increased after recanalization （P = 0.002）. The bilateral CBV showed no significant difference after surgery （P = 0.376）. Conclusions FDCT for CBV can show significant decrease of the injured side CBV at ultra-early stage of acute ischemic stroke, and the examination can be performed in the catheter room, which can shorten the examination time and provide assistance for the treatment decisions.