动态脑CT灌注成像对缺血性脑血管病的临床应用价值研究

Clinical application value study of dynamic cerebral CT perfusion imaging in ischemic cerebrovascular disease

目的探讨动态脑CT灌注成像对缺血性脑血管病的临床应用价值。方法选取2017年7月~2019年6月在汕头市龙湖人民医院接受诊治的50例缺血性脑血管病患者,根据脑血管减影造影显示的动脉狭窄率分为健侧、患侧,均进行动态脑CT灌注成像,得到动态脑CT灌注图像,参数包括达峰时间图(TTP)、脑血容量图(CBV)、脑血流量图(CBF)。比较患者两侧大脑中动脉供血区的脑CT灌注参数指标变化,观察患者发病不同病程大脑中动脉供血区动态脑CT灌注成像参数指标的变化。结果患者健侧大脑中动脉供血区的TTP、CBV、CBF等灌注参数指标高于患侧,差异有统计学意义(P<0.05);同一患者患侧比较,发病12~30 h大脑中动脉供血区的TTP、CBV、CBF等灌注参数指标高于发病<12 h,差异有统计学意义(P<0.05)。结论缺血性脑血管病患者脑灌注CT中的TTP、CBV、CBF等灌注参数指标与脑梗死的风险因素密切相关,可用于指导临床治疗方案的制订。

Objective To explore the clinical application value of dynamic cerebral computed tomography(CT)perfusion imaging in ischemic cerebrovascular disease.Methods A total of 50 ischemic cerebrovascular disease patients treated in Shantou Longhu Hospital from July 2017 to June 2019 were selected.According to the stenosis rate of cerebral subtraction angiography,the patients were divided into the healthy side and the affected side.Dynamic CT perfusion imaging was performed in all patients to obtain dynamic cerebral CT perfusion images,the parameters included time to peak(TTP),cerebral blood volume(CBV)and cerebral blood flow(CBF).The changes of cerebral CT perfusion parameters in the blood supply area of bilateral middle cerebral artery were compared,and the changes of dynamic cerebral CT perfusion imaging parameters in different course of disease were observed.Results The perfusion parameters such as TTP,CBV and CBF in the blood supply area of the healthy side were higher than those of the affected side,with statistically significant difference(P<0.05).For the same patient,The perfusion parameters such as TTP,CBV and CBF in the blood supply area of middle cerebral artery within 12-30 h of disease courses were higher than those<12 h of disease courses,with statistically significant difference(P<0.05).Conclusion CT perfusion imaging parameters such as TTP,CBV and CBF have close correlations with cerebral infarction risks factors,which can provide guidance on the planning of treatment schemes.