CT灌注成像对缺血性脑血管病患者脑血流动力学的评价

The clinical value of CT perfusion imaging in evaluating the cerebral hemodynamics in patients with ischemic stroke

目的探讨脑CT灌注成像(CTPI)中与缺血性脑血管病类型密切相关的灌注参数。方法收集短暂性脑缺血发作(TIA)和脑梗死患者各30例。采用256排螺旋CT对患者行脑CTPI,收集以下参数:脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)、达峰值时间(TTP)。采用SPSS 17.0进行统计学分析。结果 TIA组和脑梗死组患者中,r CBV均较r CBF高(Z值分别为-4.938、-3.105,均P<0.01),r MTT、r TTP无明显差异(均P>0.05)。TIA组患者r CBV-r CBF值显著高于脑梗死组(Z=-3.343,P=0.001)。结论 TIA和脑梗死患者存在不同程度的脑血流动力学异常,TIA患者脑储备能力明显好于脑梗死患者,后者的脑储备能力有更严重的损害。

Objective To investigate the parameters of CT perfusion imaging （ CTPI ） ,which is closely related to the types of ischemic stroke .Mtehods Thirty patients with transient ischemic attack （ TIA） and thirty patients with cerebral infarction were collected and were performed cerebral CT perfusion imaging by 256 slice CT.The following parameters were collected： cerebral blood flow（CBF）,cerebral blood volume （CBV）,mean transit time （ MTT） and time to peak （ TTP）.The difference between the two groups was compared by SPSS 17.0 .Results rCBV was significantly higher than rCBF in both TIA and cerebral infarction groups （ Z values were-4.938 ,-3.105 ,respectively ,all P〈0.01 ） ,while rMTT and rTTP showed no significant difference （ all P〉0.05 ） .The value of rCBV -rCBF in TIA patients was significantly higher than that in cerebral infarction patients （ Z =-3.343 ,P =0.001 ） .Conclusion Abnormal cerebral hemodynamics with varying degrees were found in patients with TIA and ischemic stroke .Of brain reserve capacity in TIA patients is much better than that in patients with cerebral infarction , the latter is more seriously damaged.