多层螺旋CT脑灌注成像超早期诊断急性脑梗死的临床研究

目的:应用多层螺旋CT (MSCT)借助特殊软件进行脑灌注成像,观察超早期急性脑梗死动态变化。方法:静脉注射1 0 0ml碘海醇,应用西门子SENSATION4型多层螺旋CT ,对2 3例发病6h以内急性缺血性脑血管病扫描观察时间—密度曲线,测定梗死区和对侧正常对照区的血流灌注值局部脑血流量(rCBF) ,局部脑血流容积(rCBV) ,平均通过时间(MTT)等,并获得相应参数的脑灌注CT成像,所有病例至少在发病1周后复查1次普通CT。结果:2 3例急性缺血性脑梗死患者中2 0例其脑梗死侧rCBE比对侧显著降低(P <0 . 0 1 ) ,有1 7例患者1周后复查CT发现其最终梗死面积比6h内脑灌注的面积有缩小(P <0 . 0 5 ) ,证明此组患者在梗死灶中心周围有缺血性半暗区存在,有3例患者1周后CT图象显示最终梗死面积与6h内脑灌注成像面积差异无显著性。结论:多层螺旋CT脑灌注成像可以在急性脑梗死发病6h内超早期明确梗死灶部位及范围,及发现缺血坏死灶周围是否存在缺血性半暗带

QUANTITATIVE ASSESSMENT OF ACUTE CEREBRAL INFARCTION USING MALTISLICE COMPUTED TOMOGRAPHYICPERFUSION IMAGING

Objective:To value the use of maltislice computed tomographyic(MSCT)perfusion imaging in the assessment of acute cerebral infarction.Methods:23 patients who initially diagnosed as acute cerebral infarction were intravenously injected 100 ml iodine each as a contrast agent in 6 hours after their outbreak of infarction.The siemens semsation 4 MSCT was used to scan the patients and form time versus concentration curve analysis of the time versus concentration curves provided various perfusion measurements,including the coparision of region cerebral blood flow(rCBF)between the necrosis region and the normal region,region cerebral blood volume(rCBV),mean transit time(MTT).As a result,dynamic perfusion images with various perfusion measurements were made throught perfusion comuted tomography.Each case had to be examined by computed tomography at least once a week after his infarction.Results:20 patient of the 23 patients were found having a lower rCBF in their necrosis region compared with the other side(P<0.01),17 patients were observed a shrink of the size of the infarction region compared the perfusion image in first 6 hours when they were re-examined by CT a week later(P<0.05),which prove the exist of ischemic penumbra area around the infarction center.Only 3 cases indicated no obvious difference according to the CT image beteen the first 6 hours and a week later.Conclusions:The maltislice computed tomographyic perfusion imaging technology can define the infarction region and it's size at the early stage of acute cerebral infarction.It also provides clues to indicated the exist of a avascular area around the necrosis centre.