320排动态容积CT全脑灌注成像技术在脑梗死中的临床应用

目的:探讨320排动态容积CT全脑灌注成像技术在脑梗死诊断中的优势及临床应用价值。方法:对42例脑梗死患者行CT全脑灌注成像,一次对比剂注射得到平扫容积图像、CT血管成像图像及全脑灌注图像,综合运用这三种检查方法全面评估脑梗死。结果:42例脑梗死患者共发现18例存在缺血半暗带(IP),其中8例超急性期6例存在IP,19例急性期8例存在IP,15例亚急性期4例存在IP。42例梗死核心区与健侧对应区比较,脑血容量(CBV)、血流量(CBF)、平均通过时间(MTT)及达峰时间(TTP)值差异均具统计学意义(P<0.05)。18例IP区与梗死核心区比较,CBV、CBF、MTT及TTP值差异均具统计学意义(P<0.05),与健侧对应区比较,CBV值差异无统计学意义(P>0.05)。结论:急性期及亚急性期脑梗死仍可能存在IP。应用320排容积CT全脑灌注成像,对脑梗死患者可明确其责任血管的狭窄部位及程度,了解病变范围及有无IP存在,实现对脑梗死的全面评估。

Clinical application of whole-brain perfnsion CT with 320-detector row CT system in cerebral infarction

Objective：To investigate the value and advantage of whole-brain perfusion CT with 320-detector row dynamic volumetric CT system in the diagnosis and clinical application of cerebral infarction.Methods：42 patients with cerebral infarction underwent whole-brain perfusion CT;unenhanced volume scan images,CT angiography and whole-brain perfusion images could be obtained in one order of contrast agent injection,comprehensive assessment of the 3 techniques were used to evaluate cerebral infarction.Results：In the 42 patients with cerebral infarction,there were 18 cases with ischemic penumbra（IP）,which were showed in 6 of 8 patients with super-acute cerebral infarction,8 of 19 patients with acute infarction,and 4 of 15 patients with subacute infarction.Compared the core area of infarct with the contralateral corresponding region,there were statistically significant difference in CBV,CBF,MTT and TTP（P0.05）.In comparing the 18 patients having IP with the infarct core area,significant statistical differences of the CBV,CBF,MTT and TTP were existed as well（P0.05）.No significant difference was found in the CBV value of IP and the contralateral corresponding region（P0.05）.Conclusions：Ischemic penumbra might still exist in acute or subacute cerebral infarction.The position and stenotic degree of the responsible blood vessels,the extent of the cerebral lesions and the existence of ischemic penumbra could be detected by application of whole-brain perfusion imaging with 320-detector row CT system,and comprehensive assessment of cerebral infarction could be achieved.