脑梗塞前期患者的脑血流动力学的改变及多排CT灌注成像表现及分期

Changes of Cerebral Hemodynamics in Patients with Pre-cerebral Infarction and Multi-slice CT Perfusion Imaging and Staging

目的探析多排CT灌注成像在脑梗塞前期患者脑血流动力学改变及分期中的应用。方法选择2013年4月-2015年4月来我院就诊的57例门诊/住院患者作为研究对象,所有患者均行常规CT平扫、增强扫描及动态CT扫描。获取r CBV、r CBF、MTT、TTP等脑血流动力学参数脑并将病侧与健侧各参数值进行比较以凸显脑梗塞前期患者脑血流动力学变化情况。结果患者病侧与健侧的CBV值接近,比较无统计学意义(P>0.05),但病侧CBF明显低于健侧、MTT与TTP则高于健侧,提示脑梗死的发生导致CBF减低、MTT与TTP延长,差异的比较有统计学意义(P<0.05)。结论多排CT灌注成像可明确提示脑梗塞前期血流动力学异常,并通过脑血流动力学参数变化幅度对脑梗塞前期进行分期,掌握脑局部低灌注的病理生理学状态,对于疾病防治具有显著临床价值。

Objective To explore the application of CT perfusion imaging in changes and staging of cerebral hemodynamics in patients with pre-cerebral infarction. Methods 57 outpatients and inpatients admitted into the hospital for treatemtn during April 2013 to April 2015 were treated as the research objects. All patients underwent conventional CT plain scan, enhanced scan and dynamic CT scan. r CBV, r CBF, MTT, TTP and other cerebral hemodynamic parameters were obtained and the parameters of the diseased side and healthy side were compared to highlight the changes of cerebral hemodynamics in patients with pre-cerebral infarction. Results The CBV values of the diseased side and healthy side of patients were close and the comparison was not statistically significant（P〉0.05）, but CBF of the diseased side was significantly lower than that of the healthy side while MTT and TTP were higher than those of the healthy side. It suggested that the occurrence of cerebral infarction resulted in decreasing CBF and prolonged MTT and TTP. The differences were statistically significant（P〈0.05）. Conclusion Multi-slice CT perfusion imaging can clearly prompted hemodynamic abnormalities of pre-cerebral infarction. And through the change amplitude of cerebral hemodynamic parameters, precerebral infarction is staged to master the pathophysiological state of regional cerebral low perfusion, which is of significant clinical value in preventing and treating the disease.