CT脑灌注与血管造影在急性脑梗死中的临床应用

目的:探讨64层螺旋CT脑灌注成像和脑血管造影技术在急性期脑梗死中的应用价值。方法:应用PhilipsBrilliance CT 64,对30例发病12h内急性脑缺血患者行CT平扫、CT脑灌注成像(CTP)和CT血管造影(CTA)检查。分析平扫及灌注成像表现,计算出缺血区脑血流参数,包括:脑血容量图(CBV)、血流量图(CBF)、对比剂平均通过时间(MTT)和对比剂峰值时间(TTP),与对侧相应区灌注参数进行比较,并重建颈段和脑内动脉CTA图像。所有病例在发病后3~14天复查CT平扫。结果:30例患者中16例头颅平扫发现早期脑梗死征象,14例常规平扫未发现异常,而CTP均发现灌注异常区。CTP表现为CBF及CBV减低、MTT及TTP延迟;患侧CBF、MTT、TTP与对侧差异有显著性意义(P<0.01),患侧CBV与对侧差异无显著性意义(P>0.01)。重建CTA图像显示16例一侧颈内动脉狭窄,8例一侧大脑中动脉狭窄(其中1例伴大脑后动脉狭窄、左侧后交通动脉闭塞);4例左侧大脑中动脉闭塞,2例左侧颈内动脉闭塞。结论:CTP能够早期、及时、准确地反映缺血部位及程度,预测半暗带;CTA可以显示病变血管的部位和程度;联合应用两者,对早期诊断急性脑缺血和指导治疗有重要价值。

The study of 64 multislice-spiral CT cerebral perfusion imaging and CT angiography in acute cerebral infarction

Objective:To evaluate the value of 64 multislice-spiral CT cerebral perfusion imaging(CTP) in acute cerebral infarction.Methods:Conventional plain CT and CTP were performed on 30 patients with acute cerebral ischemia within 12 hours of onset of symptom by Philips 64-spiral CT scanner,head and neck angiography in 72 hours.These dynamic images were processed with software package on workstation,perfusion parameters of region cerebral blood volume(CBV),region cerebral blood flow(CBF) were calculated,mean trans...