摘要
目的研究早期急性缺血性脑卒中16排螺旋CT灌注成像（CTPI）应用价值。方法对45例早期急性缺血性脑卒中（发病时间≤24h）应用16排螺旋CT依次进行头颅CT平扫与CTPI检查。结果CT平扫：敏感度46．67％，特异度72.41％。CTPI：敏感度97．78％，特异度100％。四格表X^2检验证明CTPI较CT平扫检出脑内缺血病灶更敏感（X^2=29．298，P=0．000〈0．001）。CTPI的rCBF、rCBV、rMTT、rTIP和rPE的95％置信区间（95％CI）：缺血半暗带区（IP）分别为45．45％，59．61，55．78％～67．38％，116．25％，130．55％，111．65％，118．1l％，100．33％～125．03％；梗死区分别为10．37％～15．63％，19．11％。25．15％，246．80％～294．31％，132．48％～145．92％，56．28％～76．28％。缺血半暗带和梗死区灌注参数值相关性：CBF与CBV最好，CBF与MTT及TIP与PE较好，而CBV与MTF稍差。结论CTPI能够早期诊断急性缺血性脑卒中，通过定量分析，可区分梗死区及半暗带区。对于早期选择治疗方案，尤其是早期溶栓治疗具有重要意义，同时可预测患者预后。
Objective To evaluate the application of 16 - detector spiral CT peffusion imaging （CTPI） in early acute isch- emic stroke. Methods Routine CT scan and CTPI with GE Lightspeed 16 pro CT were performed in 45 patients with acute ischemic stroke （onset within 24 hours）. Results In the present series of 45 patients, routine CT scan had sensitivity of 46.67% and specificity of 72.41%. CTPI had sensitivity of 97.78% and specificity of 100%. The results of 2 × 2 cross tabulation Chi - square test showed significant superioty in CTPI over routine CT scan（X^2 = 29.298, P = 0.000 〈 0.001）. The values of 95% confidence interval （CI） of rCBF （relative cerebral blood flow）, rCBV （relative cerebral blood volume）, rMTT （relative mean transmit time）, rTTP （relative time to peak） and rPE（relative positive enhancement integral） in ischemic penumbra （IP） were 45.45% ～ 59.61%, 55.78% ～67.38%,116.25% ～ 130.55%,111.65% ～ 118.11% and 100.33% ～ 125.03%, respectively; while those in infarction were 10.37% ～ 15.63%, 19.11% ～ 25.15%, 246.80% ～ 294.31%, 132.48% ～ 145.92% and 56.28% ～ 76.28%, resectively. Between IP and infarction, the correlationship was best in CBF with CBV, good in CBF with MTY, and relatively poor in TIP with PE and in CBV with MTT. Conclusion CTPI is useful for diagnosing early acute ischemic stroke. By quantitative evaluation, it differentiates the core of infarction from IP, providing important information for the choice of suitable therapy, especially the early adequate thrombelysis decision. It is also of prognostic significance in patients with early acute ischemic stroke.
出处
《徐州医学院学报》
CAS
2006年第3期208-211,共4页
Acta Academiae Medicinae Xuzhou
基金
江苏省卫生厅重点科研项目(H200535)
