CT灌注原始图像与CT血管原始图像的比较影像学研究

Comparative Study of CT Perfusion Source Imaging and CT Angiography Source Imaging in Acute Stroke

目的比较计算机断层扫描灌注原始图像(computed tomography perfusion source imaging,CTP-SI)与计算机断层扫描血管原始图像(computed tomography angiography source imaging,CTA-SI)在超急性期缺血性卒中诊断中的价值。方法43例急性缺血性卒中(发病时间<9h)的患者行"一站式CT"扫描,根据动脉期与静脉期CTP-SIAlberta卒中早期CT评分(Alberta Stroke Program Early CT Score,ASPECTS)将患者分为两组:不匹配组和匹配组。分析基线CTA-SI、动脉期及静脉期CTP-SIASPECTS,并与随访影像ASPECTS进行对照。结果匹配组,CTA-SI与动脉期和静脉期CTP-SIASPECTS之间的差异无统计学意义(P=0.082,0.330);不匹配组,CTA-SI与动脉期和静脉期CTP-SIASPECTS之间的差异存在统计学意义(P=0.007,0.001)。多元线性回归结果显示,匹配组CTA-SI和静脉期CTP-SI与随访影像ASPECTS的线性关系均存在统计学意义(P=0.007,0.040);不匹配组只有静脉期CTP-SI与随访影像ASPECTS之间的线性关系存在统计学意义(P=0.003)。结论与CTA-SI相比,CTP-SI也可以判断缺血的脑组织;并且,CTP-SI在鉴别梗死与非梗死的缺血脑组织方面存在优势。

Objective To compare the diagnostic value of CTP-SI（computed tomography perfusion source imaging） and CTA-SI（computed tomography angiography source imaging） in acute stroke less than 9 hours. Methods ＂One-stop shop＂ CT examination were performed in 43 patients with symptoms of acute stroke less than 9 hours. ASPECTS（Alberta Stroke Program Early CT Score） were analyzed on arterial phase CTP-SI, venous phase CTP-SI and CTA-SI, then compared the baseline ASPECTS with the follow-up imaging 2 to 7 days. Results The ASPECTS measured on CTA-SI, arterial phase CTP-SI and venous phase CTP-SI had no significant difference（P=0.082; 0.330） in match group, however, in mismatch group, the difference had statistic significance（P=0.007; 0.001）. The linear regression results suggest statistic significance between CTA-SI, venous phase CTP-SI and follow-up imaging studies（P=0.007; 0.040）in match group, While, the statistic significance was only found between venous phase CTP- SI and follow-up imaging studies（P=0.003）. Conclusion Compared with CTA-SI, CTP-SI provides similar information in predicting ischemic tissue; Furthermore, CTP-SI provides more accurate information to CTA-SI about irreversible and reversible ischemic tissue.