64层容积CT脑灌注成像对脑梗死前期的诊断价值

Evaluation of Diagnosis of 64-slice Volume CT Cerebral Perfusion Imaging in Cerebral Pre-infarction Period

目的探讨64层容积CT脑灌注成像对脑梗死前期的诊断价值。方法对36例临床诊断为急性缺血性脑血管病而常规CT平扫未发现异常的患者进行脑灌注成像检查,测量脑内感兴趣区的局部脑血流量、局部脑血容量、平均通过时间(MTT)、达峰时间(TTP),并根据脑梗死前期的分期标准进行分析。结果发现脑灌注异常34例,其中Ⅰ_1期5例、Ⅰ_2期12例、Ⅱ_1期11例、Ⅱ_2期6例。4例同时有2个部位发现异常灌注区,分别处于Ⅰ_2期和Ⅱ_1期。有2例未发现异常灌注区。患侧TTP、MTT较对侧明显延长(分别P<0.01和P<0.05)。结论64层容积CT脑灌注成像能清楚显示脑梗死前期的血流动力学异常,具有重要的诊断价值。

Objective To investigate the evaluation of diagnosis of 64-slice volume CT cerebral perfusion imaging in stages of pre-infarction period. Methods Brain CT perfusion was performed in the 36 patients with clinically diagnosed acute ischemic cerebral vascular disease and all cases showed normal with CT plain scan, regional cerebral blood flow（rCBF） , regional cerebral blood volume（ rCBV）, mean transit time（MTT） and time to peak（TTP） were measured within region of interest（ROI） of the brain after CTPI and were analysed according to the stages of pre-infarction period. Results Abnormal perfusion changes were found in 34 of 36 cases, and there were 5 cases in stage I,, 12 in stage II1 and 6 cases in stage II2. 4 cases were found abnormal perfusion c cases in stage I2, I 1cases hanges at the same slice in different parts of brain, respectively in stage I2 and stage II1. the parameters TIP and MTT was statistical significance between ROI and opposite mirror image. Conclusion CT perfusion imaging and its parameters＇ analysis may play an increasing role to delineate the depiction of cerebral hypoperfusion in pre-infarction period and have important evaluation of diagnosis.