64层螺旋 CT 头颈 CTA联合脑 CTP 对诊断急性缺血性脑血管病的临床应用价值

目的：分析64层螺旋CT头颈CTA联合脑CTP 对诊断急性缺血性脑血管病的临床应用价值。方法：应用Philips Brilliance 64层螺旋CT对我院收治的60例急性缺血性脑血管病患者进行检查，完成脑CTP 扫描，通过自带工作站系统对获得CBV、CBF、MTT 数据和图像进行分析；完成头颈CTA扫描，检查患者脑供血动脉的狭窄闭塞和斑块情况。联合CTA和CTP 扫描，计算联合诊断急性缺血性脑血管病的敏感度、特异度和准确度情况。结果：脑CTP 检查中CBF、CBV、MTT图结果的敏感度分别为63．8％、72．3％、89．3％；特异性分别为92．3％、100％、69．2％。脑CTP 对于急性缺血性脑血管病的诊断具有重要意义，其中MTT图的敏感度最高，CBV图的特异度最高，CBF图介于二者之间。脑CTP 异常患者的患侧CBF和CBV 值小于健侧，MTT值大于健侧。脑CTP 异常组患者与脑CTP 正常组患者在头颈CTA的脑供血动脉狭窄或闭塞、斑块检测结果中存在显著差异。 CTP 与CTA联合应用时CTA诊断头颈部动脉狭窄的敏感度、特异度、准确率分别为90．8％（118/130）、99．6％（773/776）、98．3％（891/906）。结论：头颈CTA联合脑CTP 对于急性缺血性脑血管病患者的诊断具有重要意义，可显著提高其早期诊断的敏感性、特异性和准确性，为临床脑血管病患者的检查诊断带来新突破和新发展。

The Diagnosis Value of 64 Layers Spiral CT of Head and Neck CTA Joint Brain CTP for Acute Ischemic Cerebrovascular Disease

Objective：To analyze clinical application value of 64 slice spiral CT,head and neck CTA＆amp;nbsp;combined with brain CTP on diagnosing acute ischemic cerebrovascular disease .Method： 60 cases of pa-tients with acute ischemic cerebrovascular disease in our hospital were tested by Philips Brilliance 64 slice spiral CT with brain CTP , the obtained CBV ,CBF,MTT data and image analyzed through own workstation system;cerebral artery stenosis and plaque of patients were tested with head and neck CTA .With the com-bined head and neck CTA , brain CTP , the diagnostic sensitivity , specificity and accuracy of patients with a-cute ischemic cerebrovascular disease were calculated .Result：In the brain CTP , the diagnostic sensitivity of CBF,CBV,MTT image were 63.8%,72.3%,89.3%, the specificity was 92.3%,100%,69.2%.The brain CTP has a great importance on diagnosing acute ischemic cerebrovascular disease , and the MTT diagram had the highest sensitivity , CBV diagram had the highest specificity , CBF between the two ones .With the com-bined head and neck CTA , brain CTP , the diagnostic sensitivity , specificity and accuracy of CTA on head and neck artery stenosis was 90.8%（118/130）,99.6%（773/776）,98.3%（891/906）.In patients with ab-normal brain CTP , he ipsilateral CBF and CBV value was less than the normal side ,and the MTT value was greater than the contralateral .There were significant differences in cerebral artery stenosis or occlusion of head and neck CTA ,patch test results of patients with abnormal ad normal brain CTP .Conclusion：The head and neck CTA combined with brain CTP has a great importance on diagnosing acute ischemic cerebrovascular disease , significantly improving the early diagnostic sensitivity , specificity and accuracy , which brings new breakthrough and development for the diagnosis of acute ischemic cerebrovascular disease .