64排螺旋CT在神经系统疾病诊断中的优势分析

目的 分析64排螺旋CT在神经系统疾病诊断中的应用优势.方法 选取经64排螺旋CT检查,怀疑有神经系统疾病的患者97例,其中常规头部CT扫描50例和横断面容积扫描冠状面重组20例,并与双螺旋CT检查70例相应病例的图像进行比较;头颈CT血管造影10例和全部脊柱CT血管造影7例,与数字减影血管造影和临床资料对照;10例13次脑灌注成像,分析其成像优势.结果 50例64排螺旋CT常规头部扫描未见或仅有轻微颅后窝伪影,而50例双螺旋CT中32例有明显的颅后窝骨伪影.20例64排螺旋CT头颅冠状重组图像质量优良,而双螺旋CT冠状扫描的20例,9例扫描角度不够,7例有伪影,增强者1例效果差.5例头颈CTA异常（4例头颈动脉狭窄或闭塞,1例脑内动静脉畸形）,4例脊柱CTA发现血管畸形（包括畸形血管位置、供血动脉和引流静脉）,均与DSA一致.10例（13次）脑灌注成像,7例短暂性脑缺血发作（TIA）表现有灌注时间延长,血流轻度减少或无减少,其中2例治疗后基本恢复正常;3例脑梗死灌注时间延长,血流明显减少.结论 64排螺旋CT能消除常规头部CT扫描时颅后窝伪影,平面重组可清楚显示颅底结构,可取代并且优于冠状位扫描;CTA能大范围准确显示头、颈和脊髓、脊柱血管病变;灌注成像范围显著扩大,准确度提高,可与静脉和同范围动脉CTA在一次增强后同时完成.

Analysis of the advantages about 64-slice SCT in the diagnosis of nervous system diseases

Objective To evaluate the advantages of 64-slice SCT in the diagnosis of nervous system diseases. Methods 50 cases with 64-slice SCT and 20 cases with coronal reconstruction were studied and compared with corresponding images with single or double spiral CT.We also studied 10 cases with head and neck CTA and 7 cases with spine CTA,and compared them with the image of DSA and their clinical data.13 brain perfusion images from 10 cases were evaluated for its advantages in imaging. Results Little of cranial posterior fossa artifact were found in 50 cases with 64-slice SCT routine CT scan of the head,but 32 cases with double spiral CT showed cranial posterior fossa artifact.The quality of reconstructed picture in 20 cases was good.The angles were not enough in 9 out of 20 cases with single or double SCT scan,7 of them had artifact,and did not show satisfied enhancement image in 1 case.5 cases with head and neck CTA (4 cases with intracranial and extracranial arterial stenosis or occlusion,1 case with cerebral vascular malformation),and 4 cases with spinal vascular malformation,including their location,feeding artery and draining vein by spine CTA were consistent with that of DSA.10 cases with 13 brain perfusion imaging were found prolonged perfusion time and decreased blood volumdifl.The blood flow parameter reflected by image is consistent with clinical data. Conclusion 64-slice SCT can eliminate the cranial posterior fossa artifact which appears in conventional CT scan of head.Plan reconstruction can display construction of skull base well,and is supposed to replace coronal scan.CTA can display the pathology of head,neck and spinal cord,and spine blood vessel in wide region.The region of perfusion imaging is enlarged remarkably,and accuracy enhanced.It can be finished with both vein and artery CTA in the same region with once enhancement.Original and reconstructedpictures made by 64-slice SCT could accelerate reform of image carrier and reading method.