全脑CT灌注联合头颈部CTA“一站式”检查在前循环急性缺血性脑卒中的诊断价值

The Value of Whole Brain CT Perfusion Imaging Combined with Head and Neck CTA one-stop examination in the Diagnosis of Anterior Circulation Acute Ischemic Stroke

目的探讨全脑CT灌注成像联合头颈部CTA“一站式”检查在急性缺血性脑卒中的临床诊断价值。方法回顾性分析我院2019年1月至2022年3月61例单侧前循环急性缺血性脑卒中患者资料;所有患者均进行头颈部CTA、全脑CTP“一站式”检查及MRI检查,记录CTP图像灌注异常区CBF、CBV、MTT、Tmax参数及CTA图像中责任血管病变节段及其狭窄情况并进行相关性分析。结果本研究共发现梗死核心91个;CTP Average图显示33例存在梗死核心,诊断阳性率为54.1%;48例存在责任血管,存在责任血管患者灌注异常阳性率高于无责任血管患者。灌注参数在核心梗死、镜像对照、缺血半暗带均具有统计学差异(P<0.05);rCBF、MTT及Tmax在缺血半暗带与镜像对照存在统计学差异(P<0.05);而rCBV则无显著统计学差异(P>0.05)。结论头颈部CTA、全脑CTP“一站式”检查,可同时获得责任血管狭窄及脑血流灌注情况等多方面的信息,为临床选择合理治疗方案提供多方面影像支持。

ObjectiveTo explore the value of whole brain CT perfusion imaging combined with head and neck CTA in the diagnosis of anterior circulation acute ischemic stroke.MethodsThe data of 61 patients with unilateral anterior circulation acute ischemic stroke treated in our hospital from January 2019 to March 2022 were retrospectively analyzed.All patients underwent head and neck CTA and whole brain CTP"one-stop"examination and MRI examination.CBF,CBV,MTT and Tmax parameters,stenosis of responsible vessels in abnormal perfusion area of CTP image were recorded and carry out correlation analysisResultsIn this study,A total of 91 core infarcts were found.CTP average showed the presence of core infarct area and ischemic penumbra area in 33 patients.the positive rate of CTP average was 54.1%;There were responsible vessels in 48 patients,The positive rate of abnormal perfusion in patients with responsible vessels was significantly higher than that in patients without responsible vessels.There were significant differences in the values of perfusion parameters between the core infarct area and the mirror control area,and between the core infarct area and the ischemic penumbra area(P<0.05);There were significant differences in the values of rCBF,MTT and Tmax between ischemic penumbra and mirror control area(P<0.05);There was no significant difference in rCBV(P>0.05).Conclusion The"one-stop"whole brain CT perfusion and head and neck CTA,we can obtain various information such as responsible vessel stenosis,and cerebral blood perfusion,effectively evaluate the degree of cerebral ischemia,and provide various image support for clinical selection of reasonable treatment scheme.