小覆盖范围CT灌注成像对急性大脑中动脉供血区脑卒中的评价

目的探讨用较小扫描范围的CT灌注成像检查对急性大脑中动脉供血区脑卒中的诊断效能。方法回顾性分析急诊接治的22例连续脑卒中患者,均在发病1～24 h行CT平扫和CT灌注成像检查。应用Z轴80 mm范围灌注参数,得出脑梗死核心区、半暗带的体积。计算半暗带/(半暗带+梗死核心区)比值。根据Z轴长度80 mm的CT灌注结果的治疗方案为基线,将较小覆盖范围获得的结果制定的治疗方案,计算较小范围灌注评价治疗的敏感性与特异性。结果当半暗带/(半暗带+梗死核心区)比值>0.2时,较小覆盖范围应用40 mm范围的CT灌注检查,可以准确评价梗死核心区与半暗带。结论大脑中动脉供血区脑卒中患者,当半暗带/(半暗带+梗死核心区)>0.2时,40 mm的Z轴覆盖范围CT灌注成像能够对病灶的范围与性质做出诊断。

Small volume coverage CT brain perfusion assessment of acute middle cerebral artery stroke

Objective To estimate the maximium diagnostic efficiency of small coverage CT brain perfusion.Methods Twenty-two patients with acute ischemic cerebral stroke,enrolled in this retrospective study,underwent perfusion CT scanning and CT perfusion imaging 1-24 h after onset of the disease.Cerebral infarction core area and penumbra volume of perfusion CT were measured with the 80 mm Z-axis coverage CT perfucion parameters.The penumbra/penumbra+infarction core area ratio was calculated.The sensitivity and specificity of small coverage CT brain perfusion were calculated with the treatment plan worked out according to the 80 mm Z-axis coverage CT brain perfucion as the baseline.Results Forty milimeter Z-axis coverage CT brain perfusion could show the accurate infarction core area and penumbra volume when the penumbra/penumbra+infarction core area ratio was>0.2.Conclusion Forty mm Z-axis coverage CT brain perfusion can show the area and nature of infarction in patients with acute middle cerebral stroke when the penumbra /penumbra+infarction core area ratio is>0.2.