CT血管成像及血流灌注对脑动脉狭窄及缺血性脑血管病的诊断价值

目的:应用多层螺旋CT(MSCT)采用CT血管成像(CTA)与CT灌注成像(CTPI)相结合的技术探讨对脑动脉狭窄及缺血性脑血管病的诊断价值及超早期治疗的价值。方法:30例急性缺血性脑血管病(AICVD)患者行CT平扫,CTA和CTPI检查。对比观察梗死区和对侧对照区,梗死病灶中心区与周边区的血流动力学参数数值;分析AICVD与CTA变化的关系。结果:30例AICVD患者,CT平扫10例短暂性脑缺血发作(TIA)患者均未见异常,20例脑梗死(CI)患者有1例有小灶性低密度。CTA显示10例TIA患者中正常8例,狭窄2例;20例CI患者中19例均有不同程度的动脉狭窄,1例正常,为脑干梗死。CTPI显示未见异常者12例,其中10例TIA,2例CI(1例基底节区腔隙梗死,1例脑干梗死)。灌注异常者18例中,梗死侧与健侧、病灶中心与周边区rCBF、rCBV、TTP的差异有统计学意义。结论:CTA联合CTPI对早期AICVD有诊断价值,并能指导临床进行合理治疗。

The Value on CTA and CTPI in Diagnosis of Cerebral Artery Stenosis and Acute Ischemic Cerebrovascular Disease

Aim:To value the use of MSCT angiography combining with perfusion imaging in the assessment of cerebral artery stenosis , acute ischemic cerebrovascular disease and early treatment. Methods: Examinations of plain scan, CTA, CTPI were underwent in 30 cases with acute ischemic cerebrovascular disease.The perfusion parameter of side of the infarct and contralateral side of the infarct,center area of the infarct and peripheral area of the infarct separately were observed and compared. The relation between the AICVD and CTA was analyzed. Results: In the 30 cases with AICVD, any abnormal density was not found in 10 cases with TIA and 19 of 20 cases with CI on plain scan (but slight lower density was found in 1 case with CI). CTA scan did not show narrowness of supplying arteries of the infarct in 8 of 10 cases with TIA, except 2 cases. CTA scan showed different degree narrowness of supplying arteries of the infarct in 19 of 20 cases with CI,except 1 case with CI.CTPI showed normal value in 12 cases(including10 cases with TIA, 2 cases with small-size infarction);and showed abnormal value in 18 cases with CI.The values of rCBF, rCBV, TTP between side of infarctand contralateral side, center area and peripheral area of the infarct were statistically significant difference. Conclusion: CTA combining with CTPI could made early diagnoss of AICVD,and could indicate the clinic treatment reasonably.