脑梗死患者脑血流动力学的多层螺旋CT灌注成像研究

目的 探讨CT灌注成像(CTPI)在老年性脑梗死脑血流动力学研究中的价值.方法 48例临床拟诊脑梗死的患者,发病24 h内行CT 16层平扫及CTPI检查,测定兴趣区的脑血流量(CBF)、对比剂平均通过时间(MTT)和对比剂峰值时间(TTP),并与对侧相应脑组织灌注参数比较;所有病例3～10 d后行MRI随访.结果 本组中40.9%的患者CT平扫显示缺血灶,93.2%的患者CTPI显示异常灌注.CTPI发现异常灌注的敏感性为93.2%,特异性为100%;缺血区CBF减低,MTT、TTP延长,与对照区域比较差异有统计学意义(P＜0.01).结论 CTPI能够敏感地反映缺血脑组织的血流动力学状态,为老年性脑梗死的早期诊断、早期治疗提供重要信息.

Abstract：

Objective To study the value of CT perfusion imaging(CTPI)on brain hemodynamic of the aged with cerebral infarction. Methods The 48 patients who were doubted with cerebral infarction underwent 16-slice CT plain scanning and CTPI within 24 hours of onset. The cerebral blood flow(CBF), mean transit time(MTT)and time to peak(TTP)of contrast-medium in region of interest(FOV)were used as brain hemodynamic parameters in comparation with contralateral regions. All cases were followed up with MRI after 3-10 days. Results Ischemia lesion was found on CT plain scanning in 40.9% of patients, while 93.2% of patients showed abnormal perfusion on CTPI. The sensibility of CTPI in identifying ischemia area was 93.2%, and the specificity was 100%. CBF in research area was significantly reduced, MTT and TTP were remarkably increased in contrast to counterparts(P＜0.01). Conclusions CT perfusion imaging can sensitively reveal the hemodynamic condition of cerebral ischemia, which could provide the important information for early diagnosis and treatment of the elderly with brain infarction.

Investigation of the value of multi-slice CT perfusion imaging on brain hemodynamic in patients with cerebral infarction

Objective To study the value of CT perfusion imaging(CTPI)on brain hemodynamic of the aged with cerebral infarction. Methods The 48 patients who were doubted with cerebral infarction underwent 16-slice CT plain scanning and CTPI within 24 hours of onset. The cerebral blood flow(CBF), mean transit time(MTT)and time to peak(TTP)of contrast-medium in region of interest(FOV)were used as brain hemodynamic parameters in comparation with contralateral regions. All cases were followed up with MRI after 3-10 days. Results Ischemia lesion was found on CT plain scanning in 40.9% of patients, while 93.2% of patients showed abnormal perfusion on CTPI. The sensibility of CTPI in identifying ischemia area was 93.2%, and the specificity was 100%. CBF in research area was significantly reduced, MTT and TTP were remarkably increased in contrast to counterparts(P＜0.01). Conclusions CT perfusion imaging can sensitively reveal the hemodynamic condition of cerebral ischemia, which could provide the important information for early diagnosis and treatment of the elderly with brain infarction.