C臂锥形束CT灌注在急性缺血性脑卒中诊治中的应用进展

Advances in the application of C-arm cone beam CT perfusion for acute ischemic stroke

急性缺血性脑卒中(AIS)具有高致死致残率。脑组织缺血时间越长临床预后越差,尽早恢复缺血区血流灌注,挽救缺血半暗带一直是AIS诊治重点,而启动再灌注治疗前快速识别半定量缺血半暗带是影像学筛查核心内容。基于DSA设备的新兴断层成像C臂锥形束CT(CBCT)与传统CT相比更有利于实现AIS一站式诊治,明显缩短缺血组织再灌注时间,获得良好临床预后。然而由于现有设备硬件和算法限制,该技术目前尚未广泛应用于临床。本文就CBCT灌注技术在AIS相关成像方法、原理及其在临床诊治中应用进展作一综述。

Acute ischemic stroke(AIS)carries high disability and mortality rate.The longer ischemic time the brain tissues suffers,the worse clinical prognosis the patients would have.Therefore,early recovery of blood perfusion in ischemic areas and rescue of ischemic penumbra have always been the focus of diagnosis and treatment of AIS,and rapid identification of semi-quantitative ischemic penumbra before initiating reperfusion treatment is the core content of imaging screening.The emerging C-arm cone-beam CT(CBCT),which is developed based on DSA device,is superior to traditional CT in achieving one-stop-shop diagnosis and treatment of AIS.C-arm CBCT perfusion can significantly shorten the reperfusion time for ischemic tissues and obtain good clinical prognosis.However,in clinical practice this technique has not been widely employed yet due to the hardware and algorithm limitations of existing available devices.This paper reviews the application progress of C-arm CBCT perfusion technology in AIS,focusing on its imaging method,imaging principle and its clinical value for diagnosis and treatment of AIS.