多层螺旋CT灌注成像在急性脑梗死诊断中的应用

目的　评价多层螺旋CT灌注成像 (MSCTPI)在急性脑梗死中的应用。方法　对 31例发病 2～ 2 4h(其中 2 1例发病 <6h为超急性期脑梗死 ,10例发病 6～ 2 4h为急性期脑梗死 )的临床诊断为脑梗死的患者行常规CT平扫及MSCTPI检查。结果　 31例患者中 2 1例临床诊断为超急性期脑梗死的患者CT平扫未见异常 ,10例急性期脑梗死的患者 8例CT平扫未见异常。而 31例灌注成像中 2 8例发现与临床症状相对应的灌注异常区 ,后经随访CT证实均为缺血性脑梗死。 3例未发现灌注异常的患者后经MRI证实 ,1例为上矢状窦静脉血栓 ,1例为脑干 (延髓 )梗死 ,1例为尾状核头部腔隙脑梗死。结论　MSCTPI可以超早期诊断急性脑梗死 ,为其早期溶栓及个体化治疗提供影像学依据

Multislice spiral CT perfusion imaging in acute cerebral infarction

Objective To explore the application of multislice spiral CT perfusion imaging (MSCTPI) in acute cerebral infarction.Methods Routine CT and MSCTPI were performed in 31 patients with acute infarction diagnosed clinically from 2h to 24h after the onset of symptoms (21 patients suffering from infarction within 6h were of overearly infarction and 10 patients from 6h to 24h were of acute infarction).Results In 31 cases,29 had routine CT negative results after onset of stroke,including 21 cases of overearly infarction,8 of acute infarction;28 cases of them were confirmed by MSCTPI as abnormal perfusion changes corresponding to clinical symptoms.The ischemic infarctions were confirmed by follow up CT;3 cases of MSCTPI had negative results;one case was superior sagittal sinus thrombosis,one case was brainstem(medulla oblongata)infarction,and the other one was in head of caudate nucleus lacunar infarction.They were confirmed by follow-up MRI.Conclusion MSCTPI can be used in diagnosis of overearly cerebral infarction,which provide imaging basis for early dissolving of thrombosis and different treatment according to individual.