VCTDSA联合CT灌注成像对急性缺血性脑卒中影像诊断价值

目的探讨容积CT数字减影血管造影VCTDSA联合CT灌注成像在急性缺血性脑卒中的诊断价值。方法对30例临床诊断为急性缺血性脑卒中的患者于发病后24h内行VCTDSA联合CT灌注成像,观察CT平扫表现及灌注图像、VCTDSA重建图像结果。测定相应区域脑血流量(CBF),脑血容量(CBV),平均通过时间(MTT)和达峰时间(TTP)。结果 25例急性缺血性脑卒中患者头部CT平扫未发现与临床症状相对应的脑缺血区,CT灌注图上可发现与临床症状相对应的脑缺血区。CT灌注成像表现为CBF下降、CBV下降、MTT延长、TTP延长或无TTP出现。VCTDSA可见23例患者相应责任血管的不同程度的狭窄,其余7例患者未检出相应责任血管狭窄。结论 CT灌注成像在急性缺血性脑卒中的早期诊断中有很重要的价值。VCTDSA能发现缺血病变的原因,为临床进一步治疗提供确切依据。

Diagnostic value of VCTDSA combined with CT perfusion in acute ischemic stroke

Objective To investigate the diagnostic value of Volume computed tomographic digital subtraction angiography(VCTDSA)combined with CT perfusion in acute ischemic stroke.Methods 30 patients with acute ischemic stroke who had VCTDSA and CT perfusion within 24h after onset of symptoms were analyzed.The plain CT scan,VCTDSA and CT perfusion images were analyzed.The CBF,CBV,MTT and TTP values were recorded.Results Plain CT scan did not show any ischemic areas in 25 patients with acute ischemic stroke.The ischemic areas were identified at CT perfusion.The ischemic area showed decreased CBF,CBV and prolonged MTT and TTP.A total of 23 patients had stenosis on VCTDSA.The remaining 7 patients did not show any vascular abnormalities.Conclusion CT perfusion is a valuable tool for early diagnosis of acute ischemic stroke.VCTDSA identifies the causes of stroke,thereby allowing acute diagnosis and treatment.