多层螺旋CT脑灌注成像联合CTA在颈动脉狭窄与脑梗死中的应用价值

目的：探讨多层螺旋CT灌注成像与CTA联合评价颈内动脉狭窄与脑梗死的应用价值。方法选择我院收治的47例急性脑梗死患者入院后立即行CT灌注成像和CTA检查。通过CTA对颈动脉狭窄程度进行评估，通过灌注图像评估脑梗死的血流动力学状态。结果47例94支血管中，脑梗死侧颈动脉血管狭窄检出率为64.0％（32/50），非梗死侧颈动脉血管狭窄检出率29.5％（13/44），两侧颈动脉血管狭窄检出率差异有统计学意义（ P＜0.05）。47例脑梗死患者中大、中、小体积梗死分别为9例、20例及18例。94支血管中45支有不同程度狭窄，轻、中、重度狭窄分别为17例、16例及9例，3例血管完全闭塞。颈动脉完全闭塞与大体积梗死的符合率100％（3/3）；重度狭窄与大体积梗死的符合率67％（6/9）；中度狭窄与中体积梗死的符合率81％（13/16）；轻度狭窄与小体积梗死的符合率为88％（15/17），差异有统计学意义（ P＜0.05）。结论多层螺旋CT脑灌注成像联合CTA能评价颈动脉狭窄程度与脑梗死的关系。

Application study of multislice spiral CT cerebral perfusion imaging combined with CTA on the evaluation of carotid stenosis and cerebral infarction

Objective To investigate the value of the multi-slice spiral CT perfusion imaging combined with CTA on inter-nal carotid artery stenosis and cerebral infarction. Methods 47 cases with acute cerebral infarction underwent CT perfusion im-aging and CTA examination. Carotid stenosis was evaluated by CTA ,hemodynamic state was assessed by cerebral perfusion images.Results in 47 patients with 94 vessels ,on cerebral infarction side ,carotid artery stenosis detection rate was 64.0%（32/50）;on non-infarcted side ,carotid artery stenosis was 29.5% （13/44）. Carotid artery stenosis detection rates of two sides were significantly different （P＜0.05）. In 47 cases of cerebral infarction ,cases with large ,medium and small size of in-farction were 9 cases ,20 cases and 18 cases respectively. There are 45 vessels with varying degree stenosis in 94 vessels ,mild , moderate and severe stenosis were 17 cases ,16 cases and 9 cases respectively ,3 cases of patients with vascular occlusion. The coincidence of carotid artery occlusion and the large volume of infarction was 100% （3/3）;The coincidence of severe stenosis and the large volume of infarction was 67% （6/9）;moderate stenosis and the volume of infarction 81% （13/16）;mild stenosis and the small volume of infarction 88% （15/17） ,the difference was statistically significant （P＜0.05）. Conclusion Multislice spiral CT cerebral perfusion imaging combined with CTA is able to evaluate the relationship between the degree of carotid ste-nosis and cerebral infarction.