CT脑灌注成像在短暂性脑缺血发作的应用价值探讨

目的探讨CT脑灌注成像(CT perfusion,CTP)在短暂性脑缺血发作(transient ischemic attack,TIA)的应用价值。方法收集我院从2013年4月至2015年4月收治的55例短暂性TIA患者作为研究对象,发病24h内进行CTP和CTA(CT angiography)检查,发病72h内进行头颅MRI(magnetic resonance imaging)和MRA(magnetic resonance angiography)进行检查,比较CTP与其他检查方法的检出结果差异,并对病灶侧与健康侧的脑灌注成像参数如获得达峰时间(time to peak,TTP)、平均通过时间(mean transit time,MTT)、脑血流量(cerebral blood flow,CBF)、脑血容量(cerebral blood volume,CBV)进行比较分析。结果 CTA检出35个病灶,MRI检出44个病灶,CTP检出59个病灶,CTP对病灶的检出率高于CTA和MR检查,具有统计学意义(P0.05);CTP检出的病灶表现分型中I1期12个,I2期29个,II1期11个,II2期7个,I2期明显多于其他分型,具有统计学意义(P0.05);CTP病灶侧的TTP值、MTT值(P0.05);CTP病灶侧的CBV值与健康侧没有明显差异(P0.05)。结论采用CT脑灌注成像检查短暂性脑缺血发作可以全面的诊断,对治疗短暂性脑缺血发作提供可靠的依据。

To Study the Application Value of CT Cerebral Perfusion Imaging in Transient Ischemic Attack

Objective To study the application value of CT cerebral perfusion imaging(CTP) in Transient ischemic attack(TIA).Methods Fifty-five cases of transient ischemic attack from April 2013 to April 2015 in our hospital were collected as research subject, all of them were performed CTP, CTA(CT angiography) in 24 hours after onset and MRI(Magnetic Resonance imaging) and MRA(Magnetic Resonance angiography) in 72 hours. The inspection results of CTA and MRI and CTP were compared, and the parameters of CTP like time to peak(TTP), mean transit time(MTT), cerebral blood flow(CBF), cerebral blood volume(CBV) were analyzed and compared between lesion side and healthy side.Results Thirty-five lesions were checked out by CTA inspection, 44 lesions by MRI, and 59 lesions by CTP. The detection rate of CTP was higher than that of CTA and MRI, and it was significantly different (P<0.05). 12 lesions were checked out in I1 period by CTP, 29 in I2 period, 11 in II1 period and 7 in II2 period, the lesions of I2 were significantly more than the other period, and it is statistically different (P<0.05), the value of TTP, MTT, CBF and CTP between the lesion and Health side was significantly different (P<0.05), the CBV value of CTP between the lesion and Health side had no significant difference (P>0.05).Conclusions The CTP inspection can make a comprehensive diagnosis for transient ischemic attack and offer reliable basis for its treatment.