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129例急性缺血性脑梗塞临床CT随诊分析——兼论急诊CT检查的时效性与诊断效果关系
引用本文:王颖,许治强,江魁明,宋亭,肖有成,李志钊,彭晞. 129例急性缺血性脑梗塞临床CT随诊分析——兼论急诊CT检查的时效性与诊断效果关系[J]. 影像诊断与介入放射学, 2001, 10(4): 205-208
作者姓名:王颖  许治强  江魁明  宋亭  肖有成  李志钊  彭晞
作者单位:510150,广州市第二人民医院放射科
摘    要:目的 探讨急性缺血性脑梗塞(AICI)不同时段的CT表现。方法 AICI129例,按发病时间和首次CT检查结果,CT分为5期:(1)HAP:超急性期6h之内,56例;(2)AP:急性期7-24h,24例;(3)SAP;亚急性期2-7d,27例;(4)SP:稳定期8-14d,7例;(5)CP;慢性期15d以上,15例,对复查病例出现的征象变化分列为5种;首次出现新病灶,原病灶扩大或增加,原病灶无变化。原病灶消失,仍然阴性等,其中以前两种变化列为阳性率统计;并按复查时间的先后分别设置四个时段;A:24h之内,B:2-7d,C:8-14d,D:15d以上。结果 首次CT检查发现病灶总阳性率为58.91%;各期的阳性率分别为:HAP21/56例,37.5%;AP14/24例,58.33%;SAP21/27例,77.78%,SP5/7例,71.43%,CP15/15例,100%,按四个不同时段复查结构显示阳性率的出现与随诊时间存在差异。结论 AICI的不同时期具有不同的CT表现,首次CT检查结果仅能说明病灶的阶段性改变;建立不同时段的CT复检制度既有利于发现新病灶及观察原病灶的变化,也有助于临床对病灶的变化和归进行评估。

关 键 词:急性缺血性脑梗塞 CT 时效性 诊断效果
修稿时间:2001-03-12

Follow-up survey of CT manifestation in acute ischemic cerebral infarction (AICI) (An analysis of 129 cases)
WANG Ying,XU Zhiqiang,JIANG Kuiming,et al.. Follow-up survey of CT manifestation in acute ischemic cerebral infarction (AICI) (An analysis of 129 cases)[J]. Journal of Diagnostic Imaging & Interventional Radiology, 2001, 10(4): 205-208
Authors:WANG Ying  XU Zhiqiang  JIANG Kuiming  et al.
Affiliation:WANG Ying,XU Zhiqiang,JIANG Kuiming,et al. Department of Radiology,Guangzhou People'.s Hospital NO: 2 Guangzhou 510150 China
Abstract:To investigate CT manifestation in different period of AICI. Methods 129 patients(male/female = 49/80) suffered from acute ischemic cerebral infarction(AICI) aged from 46 to 93 (mean 68 years) . Based on clinical onset time the patients could be divided into five groups: (1) hyperacute period (HAP): 0-6 hours, 56 cases, (2) acute period (AP): 7-24 hours, 24, (3) subacute period (SAP): 2-7days, 27, (4)steady period (SP): 8-14 clays, 7, and (5) chronic period (CP): over 15 days, 15. To survey CT signs variation by first-time scanning, the different time of follow-up reexamining included: (A) inner 24 hours 30 cases; (B) 2-7 days 48; (C) 8-14 days 63 and (D) over 15 days 39. Results The first-time CT scanning showed that the infarction focus discovering - rate was 58. 91% (76/129 cases) and HAP 37. 5%, AP 56%, SAP 77. 78%, SP71.43%, CP 100% separately. Recheck - up based on different period were made and their positive - rate separately were: (A) 30/30 cases 100%; (B) 25/48 cases 52.08%; (C) 10/63 cases 15.87% and (D) 5/39 cases 12.82%. Conclusion There were different cerebral infarction manifestations in various periods of AICI. The first time CT scanning may be showed its staging sign only. CT follow - up survey was not only useful to discover a newly focus and obtain area - injuring distinct variation, but also helpful in e-valuating the clinical treatment effect and the inclination of the patient.
Keywords:Acute cerebral ischemia infarction  Follow - up  Tomography   X - ray computed
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