64排CT脑灌注对脑组织缺血程度的应用研究

64 row CT cerebral perfusion applied research of brain ischemia

目的探讨应用64排CT脑灌注评价脑组织缺血程度。方法 40例临床诊断急性脑梗塞,CT灌注显示单侧脑叶灌注异常患者,结合MRI判断梗塞,根据脑血流量进行分组,A组(低灌注组)与B组(梗塞组),分别评价两组的脑血流灌注参数变化并进行对比分析。结果 40例患者中,A组18例,CTP图异常低灌注区表现为MTT延长(R约为1.28)、CBF可正常或轻度升/降、CBV基本无变化或轻度降低,其中仅MTT延长有统计学意义(P<0.01);B组梗塞组22例,对比MRI图梗塞周边IP区异常灌注表现为MTT延长(R约为1.48)、CBF明显下降(R约为0.45)、CBV轻度降低,其中MTT延长有统计学意义(P<0.001),CBF下降有统计学意义(P<0.01);梗塞中心区表现为MTT延长(R约为1.64)、CBF明显下降(R约为0.36)、CBV明显降低(R约为0.37)。其中MTT延长有统计学意义(P<0.001),CBF下降有统计学意义(P<0.01)。结论脑组织低灌注区与梗塞中心区及周边IP区各灌注参数有显著差异,根据灌注参数的变化特点可对缺血梗塞的程度作出影像评估,当MRI未见急性梗塞时,CT灌注r CBF<0.5,提示梗塞风险极高,指导临床应进行早期干预治疗。

Objective Application of 64 row CT cerebral perfusion brain tissue ischemia. Methods 40 cases of clinical diag-nosis of acute cerebral infarction,patients with unilateral lobe brain perfusion CT perfusion showed abnormal,in combination with MRI to determine infarct,according to the cerebral blood flow group,group A （low perfusion group） and group B （infarction group）, respectively,evaluation of two groups of cerebral blood flow perfusion parameters and comparison analysis. Results Of 40 cases, 18 cases of group A,CTP anomaly low perfusion of figure is determined by MTT extend approximately 1.28 （R）,decreased CBF mild,CBV basic no change Or moderately reduced,only determined by MTT extension was statistically significant （P〈0.01）;Infarc-tion group,22 cases of group B,infarction area surrounding IP abnormal perfusion is determined by MTT extend approximately 1. 48（R）,CBF significantly decreased approximately 0.45（R）,CBV moderately reduced,which extended determined by MTT was sta-tistically significant （P〈0.001）,decrease CBF was statistically significant （P〈0.01）;Infarction district performance is determined by MTT extend approximately 1.64（R）,CBF significantly decreased approximately 0.36（R）,significantly lower CBV （approximately 0. 37）R. Which determined by MTT extension was statistically significant （P〈0.001）,CBF decline was statistically significant（P〈0.01）. Conclusion Brain tissue hypoperfusion area with the infarction in central and peripheral IP area the perfusion parameters have significant differences,according to the variation of perfusion parameters characteristics can make the image on the degree of is-chemic infarction assessment,when rCBF〈0.5,suggesting infarction risk is extremely high,the clinical guidance for early interven-tion treatment.