320排CT全脑灌注成像对急性大脑中动脉栓塞溶栓治疗前后的价值研究

目的探讨320排容积CT全脑灌注成像在急性大脑中动脉栓塞诊治中的应用价值。方法利用320排容积CT对10例急性大脑中动脉栓塞病例溶栓治疗前后进行全脑灌注扫描,利用动态容积原始数据重建容积图像,利用软件生成相应的全脑灌注三维图像;测量脑血容量(rCBV)、脑血流量(rCBF)及平均通过时间(MTT)值,进行前后定量比较。结果治疗前全部患者存在脑灌注异常区域,患侧与健侧比较,rCBV、rCBF减低,MTT延长,差异具有统计学意义(P0.05)。治疗后异常灌注区域rCBV、rCBF增高,治疗前后比较,差异具有统计学意义(P0.05)。结论 320排容积CT全脑灌注成像能够快速、准确反映缺血部位及范围,为指导急性大脑中动脉栓塞患者进行及时有效的溶栓治疗以及疗效的评价提供了可靠依据。

The Application Value of Patients Before and After Thrombolytic Therapy for Acute Middle Cerebral Artery Embolization un- der Guidance of Whole-Brain Perfusion CT with 320-Detector Row CT System

Abstract] Objective To evaluate the application value of whole-brain perfusion CT with 320-detector row CT system in patients suffering from acute middle cerebral artery embo- lization diseases.Methods Ten patients with acute middle cerebral artery embolization under- went whole-brain perfusion CT with 320-detector row CT system before and after throm- bolytic therapy. Images were generated with volume rendering reconstruction. And use the software to generate the whole brain perfusion three-dimensional image, measuring regional cerebral volum （rCBV）, regional cerebral flow （rCBF）, mean transit time （MTT） and then quantitative comparison was made before and after treatment. Results Before thrombolytic treatment,the abnormal regional cerebral perfiasion in all patients was found by CTPI, rCBVand rCBF were all reduced, MTT was extended. Abnomlal regional and contralateral comparison, the difference was statistically significant （ P ~ 0.05 ）. Aker treatment, rCBV and rCBF in- creased significantly compared with that before treatment, the difference was statistically sig- nificant （ P ~ 0.05 ）. Conclusion Whole-brain perfusion CT with 320-detector row CT system can rapidly and accurately reflect the location and extent of ischemia,and provide reliable basis in acute cerebral artery embolism patients with timely and effective thrombolysis treatment and curative effect evaluation.