多层螺旋CT脑灌注成像在急性脑缺血中的应用

目的探讨多层螺旋CT脑灌注成像在急性脑缺血中的应用价值。方法应用GE lightspeed 16层螺旋CT扫描机,对经证实的16例急性脑缺血患者先行CT平扫,选定感兴趣区行多层螺旋CT脑灌注成像,经灌注软件处理,计算出局部血容量图(rCBV)、局部血流量图(rCBF)、对比剂平均通过时间(MTT)、对比剂峰值时间(TP),并与对侧相应脑组织灌注参数进行比较。所有病例均经CT随访或经MRI证实,所有病例联合头颈部CTA扫描。结果16例患者中15例其脑缺血侧rCBF减低,MTT、TP延长,rCBV正常或轻度降低,存在半暗区;4例患者rCBV未显示病灶。1例患者rCBF减低,MTT、TP延长,rCBV明显下降,经随访证实为脑梗死。结论多层螺旋CT脑灌注成像能早期发现脑缺血灶部位和范围及推测半暗带区域、评估脑缺血预后,是一种最具潜力的脑缺血检查方法。

The application of mulit-slice spiral CT cerebral perfusion imaging in cerebral ischemia

Objective To investigate the application of mulit-slice spiral CT (MSCT) cerebral perfusion imaging in cerebral ischemia. Methods 16 cases of acute cerebral ischemia patients were perfused by GE lightspeed 16 spirals CT scanner, after plain CT scan. Interested area were designated, perfusion parameters of region cerebral blood volume (rCBV), region cerebral blood flow (rCBF) were calculated mean transit time (MTT) and time to peak (TP) were measured and the parameters were compared with the opposite sides of brain regions in correspondent. All cases were confirmed by CT follow-up or the MRI and a head-neck CTA scan were used in the same time. Results The rCBF results were decreased, MTT and TP values were prolonged, rCBV were normal or mildly reduced and penumbra were existed in the 15 eases. The rCBV in 4 cases were not demonstrated. The rCBF was decreased, MTT and TP was prolonged, rCBV was significantly dropped in I case suffered from brain stem which was confirmed by follow-up. Conclusion The MSCT cerebral perfusion imaging is available to detect the a-cute cerebral ischemia spot and estimate the scope and extrapolates penumbra region. The MSCT is tested to be one of the most valuable methods to check acute cerebral ischemia.