磁共振灌注成像与CT灌注成像在老年缺血性脑血管病患者中的应用

Application of Magnetic Resonance Perfusion-Weighted Imaging and CT Perfusion Imaging in Elderly Patients with Ischemic Cerebrovascular Disease

目的分析磁共振灌注成像(PWI)与CT灌注成像(CTPI)在老年缺血性脑血管病(CVD)患者中的应用价值。方法选取2016年5月至2018年5月我院收治的老年缺血性脑血管病90例,均接受PWI与CTPI检查,分析其脑血流量(CBF)、脑血容量(CBV)、达峰时间(TTP)、对比剂平均通过时间(MTT),比较两种方法对脑梗死灶(CI)与短暂性脑缺血(TIA)检出率及诊断效能。结果 90例患者阳性病灶共498个,PWI检出率72.69%(362/498)与CTPI91.57%(456/498)比较差异有统计学意义(P<0.05);PWI中,CI患侧、TIA患侧CBF较健侧低(P<0.05);CTPI中,CI患侧CBF、CBV低于健侧,而TTP、MTT较健侧延长,TIA患侧仅TTP与MTT较健侧延长(P<0.05);CTPI诊断灵敏度、准确度高于PWI(P<0.05)。结论与PWI相比,CTPI检查中若灌注参数变化较大可提示CI病变,对CVD有较高灵敏度、准确度,整体诊断效能更好。

Objective To analyze the value of magnetic resonance perfusion-weighted imaging(PWI) and CT perfusion imaging(CTPI) in elderly patients with ischemic cerebrovascular disease(CVD).Methods 90 elderly patients with ischemic CVD who were admitted to the hospital between May 2016 and May 2018 were selected as the subjects.All of them completed PWI and CTPI examinations.The cerebral blood flow (CBF),cerebral blood volume (CBV),time to peak (TTP) and mean transit time (MTT)] were analyzed.The detection rates and diagnostic efficiencies of the two methods for cerebral infarction (CI) and transient ischemic attack (TIA) were compared.Results A total of 498 positive lesions were detected in the 90 patients.The detection rates of PWI and CTPI were 72.69% (362/498) and 91.57%(456/498),respectively (P<0.05).PWI showed that CBF on affected sides of patients with CI andTIA was lower than that on healthy sides (P<0.05).CTPI showed that CBF and CBV on affected sides of patients with CI were lower than the healthy side,while TTP and MTT were longer than the healthy side.For patients with TIA,TTP and MTT were longer than the healthy side(P<0.05).The diagnostic sensitivity and accuracy of CTPI were higher than PWI (P<0.05).Conclusion Compared with PWI,great changes in perfusion parameters of CTPI may indicate CI lesions.The latter has higher sensitivity and accuracy in the diagnosis of CVD,with better overall diagnostic efficiency.