640层CT灌注联合血管成像在脑梗死超早期溶栓中的指导意义

目的 探讨640层CT灌注联合血管成像在脑梗死超早期溶栓中的指导意义。方法 对30例脑梗死超早期的患者，进行脑部CT平扫及640层CT灌注联合血管成像检查，根据脑血流量（ CBF ）、脑血容量、平均通过时间、达峰时间的变化及左右两侧CBF的比值，判定有无缺血半暗带；同时选择未做CT灌注检查的38例溶栓患者，对比它们之间的疗效。结果 灌注指导的动静脉溶栓疗效优于非灌注指导的动静脉溶栓疗效。结论 40层CT灌注联合血管成像在脑梗死超早期溶栓中具有指导意义，它能显示头颈部血管狭窄程度，确定有无缺血半暗带，可指导早期临床干预性溶栓或进行血管重建治疗，减少死亡率和致残率的发生。

The guiding significance of the 640 layer CT perfusion combined with the vascular imaging in thrombolysis therapy for the super acute cerebral in-farction

Objective To investigate the guiding significance of 640 layer CT perfusion combined with vascular imaging in thrombolytic therapy for super acute cerebral infarction .Methods 30 cases of patients with superacute cerebral infarction were taken the examination of brain CT scan and 640 CT layer perfusion combined with the vascular imaging.The ischemic penumbra were determined according to the change of cerebral blood flow （CBF）,regional cerebral blood volume （rCBV）,mean traverse time（MTT）and time to peak（TTP）in region of interest（ROI）and the ratio of left and right sides of CBF .At the same time ,38 patients were chosen to give thrombolytic therapy without CT perfusion imaging （20 patients with arterial thrombolytic therapy and 18 patients with intravenous thrombolytic therapy ） . Compare their discrepancy in efficacy .Results The effect of arteriovenous thrombolytic therapy guided by CT perfusion is better than that of non perfusion guidance of arteriovenous thrombolytic therapy .Conclusion It has a guiding significance in thrombolytic therapy for super acute cerebral infarction to make 640 CT perfusion combined with vascular imaging ,which can show that the degree of head and neck vascular stenosis and determine ischemic penumbra for guiding early clinical interventional thrombolytic therapy or vascular reconstruction treatment in order to save ischemic penumbra and restore the blood perfusion of ischemic brain tissue as soon as possible .It has crucial clinical value to improve the prognosis and reduce the incidence of mortality and morbidity .