超急性期脑梗塞动态增强CT扫描研究

Dynamic CT scanning for ultra-acute phase brain infarction

目的探讨动态增强CT扫描对超急性期脑梗塞的诊断及预后价值。方法对50例临床出现单侧脑梗塞症状体征、起病时间在20h内患者对疑拟脑梗塞缺血病灶进行动态CT扫描,选取可疑病灶及对侧相应位置进行感兴趣区的时间-密度曲线绘制,记录曲线峰值(H)、曲线峰值出现时间(T)、曲线下面积(S)及计算它们的差ΔH、ΔT、ΔS值,比较两侧有无差异,随访分析影响预后的征象和参数。结果50例患者中,44例H值低于对侧(P<0.01);39例T值迟于对侧(P<0.01);41例S值小于对侧(P<0.01)。随访至病情稳定,预后好23例,一般17例,差10例,三者ΔH、ΔT、ΔS值比较差异有显著性(P<0.05或0.01)。结论动态增强CT扫描对早期脑梗塞有较高的诊断价值,并且有助于估计患者的预后。

Objective To assess the values of CT for diagnosis and prognosis of ultra-acute phase brain infarction.Methods 50 patients with unilateral brain infarction symptoms and signs within 20-hour attack were selected in this study. The doubted brain infarction foci were received CT scanning.Time-density curve graph was drawn for doubted foci and their corresponding opposite site.The curve peak value（H）,curve peak appearing time（T）,and area under curve（S） were recorded and their difference values of △H,△T,△S were calculated.A comparison of the images presentation between the two sides and a follow-up analysis of the images and parameters affecting prognosis were performed.Results Among 50 patients,of 44 cases had lower H values than the opposite sides（P〈0.01）; of 39 cases had delayed peak time（P〈0.01）;of 41 cases had smaller S values（P〈0.01）.A follow-up till the stability of the disease showed that 23 cases presented with good results,17 with common results,and 10 with worse results.Compared the △H,△T,△S values between these three groups,there were statistically significant differences（P〈0.05 or 0.01）.Conclusion Dynamic enhancement CT scanning is of great value for early diagnosis of brain infarction and helps to predict the prognosis of disease.