320排CT在短暂性脑缺血发作中的应用价值初探

Application value of 320-slice CT in transient ischemic attack

目的 初步探讨320排容积CT在短暂性脑缺血性发作（TIA）的应用价值. 方法 在11例TLA患者发作间隙期应用320排容积CT进行一站式CT扫描,收集患者的头颅平扫、CT血管造影（CTA）及全脑灌注的信息,对影像资料进行综合分析.观察TIA患者的脑血管及其组织单元的病变情况. 结果 11例患者头颅CT平扫均未发现明确的责任病灶,3例行MRI无阳性发现;CTA结果显示,10例患者责任病灶区域内脑血管网明显稀疏,8例发现有相对应的血管明显变细,2例血管栓塞同时存在代偿血管形成.11例全脑灌注图像显示与临床症状相对应的灌注区达峰时间、平均通过时间延迟,5例脑血流量下降,3例脑血容量轻度增加. 结论 320排容积CT灌注成像可以通过一次对比剂注射,获得常规CT扫描、全脑灌注、CTA的数据,实现对缺血性脑血管病的全面评估.

Objective To explore the application value of 320-slice volume CT in detecting the cerebral transient ischemic attack （TIA）. Methods One-stop CT scan was performed at intermission of onset on 11 patients with cerebral TIA; the data of plain CT scans, CT angiography （CTA） and whole brain perfusion on these patients were collected. Analysis by synthesis was performed on these imaging data. Results No lesions responsible for the attack were found in the brains of 11 patients with TIA under plain CT scan; 3 of them performed MRI did not have positive results. CTA indicated that the vascular networks in 10 patients were obviously sparse in the region of lesions responsible for the attack;the corresponding vessels in 8 of them became thin; both vascular thrombosis and compensatory angiogenesis occurred in 2 patients. The cerebral perfusion indicated that perfusion areas corresponding to clinical symptoms displayed delayed mean transit time and time to peak level in these 11 patients.Decreased regional cerebral blood flow was noted in 5 patients and regional cerebral volume increased mildly in 3 patients. Conclusion The 320-slice-volume CT perfusion imaging can obtain the information about whole brain perfusion, routine CT scan and CTA by injecting a kind of contrast medicament for only one time, thus can assess the ischemic cerebrovascular disease comprehensively.