动态CT脑血流灌注测量及临床初步应用

Measurement of Cerebral Perfusion by Dynamic CT: Preliminary Application

目的 探讨动态CT脑血流灌注测量的临床应用。方法 13名正常成人、5名临床疑有脑缺血患者和 2名临床初诊为继发性帕金森病患者进行了动态CT脑血流测量。结果 正常脑灰质血流灌注量为 5 9.3～ 96 .8ml·min-1·10 0 g-1,平均 76 .2ml·min-1·10 0 g-1;正常脑白质血流灌注量为 2 7.1～ 43.1ml·min-1·10 0 g-1,平均 33.9ml·min-1·10 0 g-1。 5例临床疑有缺血性脑血管病中 ,4例发现局部脑血流灌注量下降 ,1例见局部脑血流灌注量增加。 2例临床初诊继发性帕金森病中 ,1例见左侧壳核血流灌注量下降 ,1例双侧脑血流灌注量未见明显差异。结论 动态CT脑血流灌注测量可以显示正常脑组织以及病变的血液动力学变化。

Objective To evaluate the clinical measurement of cerebral perfusion by dynamic CT. Methods Thirteen normal adults were examined by dynamic CT for the measurement of cerebral blood flow (CBF). Another dynamic CT scans with the measurement of CBF were performed separately to rule out cerebral ischemia in 5 cases and secondary Parkinson disease in 2. Results Normal cerebral cortical perfusion was measured at 59.3～96.8 ml·min -1 ·100g -1 with the mean value 76.2 ml·min -1 ·100g -1 . Normal white matter perfusion was measured at 27.1～43.1 ml·min -1 ·100g -1 with the mean value 33.9 ml·min -1 ·100g -1 . In 5 cases of suspending cerebral ischemia, one showed increase of CBF and 4 presented decrease of CBF. In 2 cases of suspending secondary Parkinson disease, one appeared decrease of CBF and other one was normal. Conclusion Dynamic CT scan with the measurement of CBF can demonstrate the hemodynamic status of normal brain and pathological lesion. Combined with routine CT scan, measurement of cerebral perfusion by dynamic CT is an ideal method to show the morphological and functional changes of brain tissue simultaneously. [