CT脑灌注与血管造影在急性缺血性脑卒中的临床应用与分析

Application analysis of the clinical value of CT cerebral perfusion and angiography in acute ischemic stroke

目的探讨CT脑灌注(CTPI)与血管造影在急性缺血性脑卒中中的临床应用价值。方法选择29例急性缺血性脑卒中患者为研究对象,采用东芝Aquilion 64排CT行头颈部CTA及CTPI检查,观察两者对急性缺血性脑卒中诊断情况,分析CTPI与CTA对急性缺血性脑卒中诊断的一致性。结果①29例患者CT灌注图上发现与临床症状相对应的灌注异常区共25例,阳性率为86.2%(25/29),高于普通CT扫描的27.6%(8/29),差异具有统计学意义(P<0.05)。②灌注异常区的CBF、CBV、MTT三组参数值与镜像健侧相比差异有显著统计学意义(P<0.05);③CTA血管检查结果发现单纯颈内动脉狭窄5处;单纯颅内动脉狭窄10处;颈内动脉及颅内动脉均狭窄4例。④病例组CTPI联合CTA检查结果比较,病例组存在责任血管的患者CTPI检查阳性率为65.51%(19/29)高于无责任血管者的20.69%(6/29),差异具有统计学意义(P<0.05)。结论 CTPI与CTA可以清晰的显示缺血性脑卒中脑内病灶及责任动脉,能够提高更多有价值的信息。

Objective To investigate the CT cerebral perfusion （CTPI） and angiography in the acute phase of ischemic stroke clinical application value. Methods 29 cases of patients with acute isehemic stroke as the object of study,The Toshiba Aquilion 64 rows of CT CTA and CTPI examination of head and neck,Observation of both for the diagnosis of acute ischemic stroke,Analysis of CTPI and CTA on the consistency of the diagnosis of acute ischemic stroke. Results （1） 29 cases of patients with CT perfusion map that corresponds with the clinical symptoms of abnormal perfusion areas a total of 25 cases,the positive rate was 86. 2% （25/29）, Higher than normal CT scans of 27. 6% （8/29）, the difference was statistically significant （P〈0. 05）. （2）Abnormal perfusion region of CBF, CBV, MTT parameter values and the mirror contralateral with significant difference （P〈0.05） ;（3）CTA showed vascular stenosis of internal carotid artery in 5; only 10 of intracranial artery stenosis; carotid and intraeranial arteries stenosis in 4 cases. （4）the positive rate of CTPI examination of patients with case group has the responsibility blood vessel was 65.51% （19/29） higher than that in the non responsible vessels were 20.69% （6/29）,the difference was statistically significant （P〈0. 05）. Conclusion CTPI and CTA can display the lesion and responsibility of arterial ischemic stroke brain dear, can improve more valuable information.