摘要
目的:探讨多层螺旋CT灌注成像(MSCTPI)对急性脑缺血的早期诊断价值。方法:对2 1例临床诊断急性缺血性脑血管病的患者于发病后1～12h内,先行常规CT平扫后再行CT灌注成像(CTPI) ,全部病例3～7天内复查CT及临床随访。结果:首次常规CT平扫显示:2 1例患者发病后1～12h内,3例初诊为脑梗死;未见异常者18例,经复查CT及临床随访证实,2例为短暂性脑缺血发作(TIA) ,16例为脑梗死。CTPI显示:2 1例患者发病后1～12h内,灌注正常者4例;灌注异常者17例,CTPI显示患者感兴趣区内局部血流量(rCBF)、对比剂达峰时间(TP)、平均通过时间(MTT)改变明显,病灶侧与健侧、病灶中心区与周边区比较,差异有显著意义(P <0 .0 5 )。结论:MSCT的发展促进了CTPI在急性脑缺血中的应用,通过分析感兴趣区的血流灌注状况,可以早期明确病灶的部位、大小及范围,显示病灶周围缺血半暗带的存在,对患者选择有效治疗方案和判断预后具有重要意思。CTPI对感兴趣区外的病灶和小体积病灶不敏感。
Objective:To investigate the early diagnostic value of multi-slice computed tomographic perfusion imaging (MSCTPI) in acute cerebral ischemia.Methods:Conventional computed tomography (CT) and CTPI were performed in turn within 1～12 hours of symptom onset in 21 patients with acute cerebral ischemi diagnosed by clinic.All patients were counterchecked by regular CT in 3～7days.Results:In 21 cases,3 cases diagnosed as cerebral infarction obtained regular CT positive results. In 18 having regular CT negative results,16 had cerebral infarction,and the other 2 had transient ischemic attack(TIA). 17 cases were confirmed by CTPI as having ischemic lesions, whose regional cerebral blood flow(rCBF),time to peak(TP),mean transit time(MTT) in 17 cases with CTPI positive were found obviously changed.The side of ischemic lesion as compared with the opposite,and the core of ischemic lesion as compared with peripheral zone were found changed significantly (P<0.05).Conclusion:The development of MSCT accelerate the application of CTPI in acute cerebral ischemia,which can be used to determine the position,range and area of the ischemic lesion and penumbra by analysis on blood perfusion state.It should be meaningful for evaluating prognosis and giving effectual treatment to the patients with acute cerebral ischemia.CTPI has little sensitivity in confirming the ischemic lesion out of the ROl or with small volume.
出处
《医学影像学杂志》
2005年第6期445-448,共4页
Journal of Medical Imaging
关键词
脑缺血
灌注
体层摄影术
X线计算机
半暗带
Cerebral ischemia
Perfusion
Tomography, X-ray computed
Penumbra
