急性脑梗死治疗前后脑血流动力学改变:CT灌注成像

Cerebral hemodynamics before and after treatment of acute cerebral infarction: CT perfusion imaging

目的 观测急性脑梗死治疗前后多层螺旋CT灌注成像 (MSCTPI)的脑血流动力学指标变化。方法 3 1例发病 6～ 2 2h的临床诊断为急性脑梗死的患者 ,分别于发病第 1天 ,第 7～ 2 1天行常规CT平扫及MSCTPI检查。结果 治疗后病变区血流量、血容量较治疗前均增加 (t =4.5 7,P <0 .0 1;t=3 .81,P <0 .0 1) ;达峰时间较治疗前缩短 (t =3 .62 ,P<0 .0 1)。结论 急性脑梗死治疗前后CT灌注成像的脑血流动力学指标变化明显 ,提示早期干预具有治疗效果。

Objective To observe and measure the changes of cerebral hemodynamics before and after treatment of acute cerebral infarction. Methods Thirty one patients with acute infarction diagnosed clinically from 6 to 22 h after the onset of symptoms, underwent routine CT and multislice CT perfusion imaging (MSCTPI) exmined after onset 1 day, 7-21 day, respectively. In the perfusion images, the cerebral blood flow (CBF), cerebral blood volume (CBV), and time to peak (TP) of patients were measured respectively within the specific regions of interest (ROI) of the brain, and quantitative analysis was performed. Results CBF, CBV on ischemic lesion of patients increased after treatment compared with that before treatment ( t =4.57, P <0.01; t =3.81, P <0.01). TP of the patients after treatment was shorten compared with that before treatment ( t =3.62, P <0.01). Conclusion Significant changes of cerebral hemodynamics exist before and after treatment of acute cerebral infarction, indicting that early intervention is effective in the treatment of acute cerebral infarction.