64排螺旋CT灌注成像在超急性期脑梗死的应用

The preliminary application of 64-multidetector spiral CT cerebral perfusion imaging in patients with hyperacute infarct

目的探讨64排螺旋CT脑容积灌注成像在超急性期脑梗死的应用价值。方法对2例缺血性卒中患者,于发病6h内行CT平扫及CT脑容积灌注成像,分析平扫及灌注表现,测量缺血区的灌注参数值,并应用灌注扫描图像重建Willis环动脉。结果2例患者常规CT平扫未发现异常;而CT脑容积灌注成像发现与临床症状相对应的灌注减低区,表现为脑血流量及脑血容量减低、平均通过时间延迟;重建Willis环动脉图像均显示左侧大脑中动脉闭塞。结论CT脑容积灌注成像能够快速、准确反映缺血部位及范围,重建血管成像可以判断闭塞血管,对早期诊断缺血性卒中和指导溶栓治疗有重要价值。

Objective To evaluate the application of 64-multidetector spiral CT cerebral perfusion imaging in patients with hyperacute infarct. Method Conventional plain CT and CT perfusion were performed on 2 patients with hyperacute isehemic stroke within 6 hours after onset. Dynamic CT cerebral perfusion images were processed with the Perfusion CT 3 software package on GE workstation. Quantitative analysis of cerebral perfusion parameters was carried out on perfusion images. CT angiography was constructed by dynamic cerebral perfusion images. Results In 2 patients with hyperacute isehemic stroke, conventional plain CT were normal. However, abnormal perfusion changes in accordance with clinical symptoms were found. Cerebral blood flow and cerebral blood volume were decreased, and mean transit time was delayed. CT angiography demonstrated left middle cerebral artery occlusion. Conclusions CT perfusion could show the extent of perfusion disturbances and the occlusion of artery in patients with hyperacute stroke.