256排CT一站式检查评估缺血性脑卒中且有缺血半暗带患者脑灌注参数及血管狭窄程度的价值分析

Value analysis of 256-slice CT one-stop examination in evaluating cerebral perfusion parameters and degree of vascular stenosis in ischemic stroke patients with ischemic penumbra

目的 分析256排CT一站式检查评估缺血性脑卒中且有缺血半暗带患者脑灌注参数及血管狭窄程度的价值。方法 42例行256排CT一站式检查并确诊为缺血性脑卒中且有缺血半暗带患者,分析256排CT一站式检查患者的脑灌注参数[脑血容量(CBV)、脑血流量(CBF)、达峰时间(TTP)、平均通过时间(MTT)]及脑血管狭窄程度。结果 CT平扫检查结果显示, 42例患者发生缺血性脑卒中且有缺血半暗带,影像学图像显示病变区域存在轻度密度减小,还观察到半暗带、大脑中动脉致密征。CT脑灌注成像(CTP)检查结果显示, 42例患者存在灌注异常情况,且42例患者患侧和健侧的CBV比较,差异无统计学意义(P>0.05);患侧的CBF(20.57±11.31)ml/(100 g·min)显著低于健侧的(44.26±17.23)ml/(100 g·min), MTT(10.00±5.46)s、TTP(6.10±3.73)s均明显长于健侧的(3.07±0.75)、(2.36±2.73)s,差异具有统计学意义(P<0.05)。CT血管造影(CTA)检查结果显示,相应区域血管呈轻中度狭窄患者20例,重度狭窄或闭塞患者22例。重度狭窄或闭塞患者的CBV、CBF及MTT与轻中度狭窄患者比较,差异均无统计学意义(P>0.05);轻中度狭窄患者TTP(4.50±1.36)s显著短于重度狭窄或闭塞患者的(7.55±4.56)s,差异具有统计学意义(P<0.05)。结论 256排CT一站式检查能够较好地检出缺血性脑卒中且有缺血半暗带患者,并可明确病变部位及血管狭窄程度,可为缺血性脑卒中且有缺血半暗带患者的临床诊治提供参考,值得临床推广使用。

Objective To analyze the value of 256-slice CT one-stop examination in evaluating cerebral perfusion parameters and degree of vascular stenosis in ischemic stroke patients with ischemic penumbra.Methods 42 patients underwent 256-slice CT one-stop examination and were diagnosed as ischemic stroke with ischemic penumbra.The cerebral perfusion parameters[cerebral blood volume(CBV),cerebral blood flow(CBF),time to peak(TTP),mean transit time(MTT)]and cerebrovascular stenosis degree of the 256-slice CT one-stop examination were analyzed.Results Plain CT scan results showed that 42 patients had ischemic stroke and ischemic penumbra.Imaging images showed a slight decrease in the density of the lesion area,and penumbra and middle cerebral artery density sign were also observed.The results of CT perfusion(CTP)showed that 42 patients had abnormal perfusion,and there was no statistically statistical significance in CBV between the affected side and the healthy side of 42 patients(P>0.05).CBF of(20.57±11.31)ml/(100 g·min)on the affected side was significantly lower than that of(44.26±17.23)ml/(100 g·min)on the healthy side;MTT of(10.00±5.46)s and TTP of(6.10±3.73)s on the affected side were significantly longer than those of(3.07±0.75)and(2.36±2.73)s on the healthy side;the differences were statistically significant(P<0.05).CT angiography(CTA)showed 20 patients with mild-to-moderate stenosis and 22 patients with severe stenosis or occlusion.There was no statistically significant difference in CBV,CBF and MTT between patients with mild-to-moderate stenosis and patients with severe stenosis or occlusion(P>0.05).TTP of(4.50±1.36)s in patients with mild-to-moderate stenosis was significantly shorter than that of(7.55±4.56)s in patients with severe stenosis or occlusion,and the difference was statistically significant(P<0.05).Conclusion 256-slice CT one-stop examination can better detect ischemic stroke patients with ischemic penumbra,and can identify the lesion site and the degree of vascular stenosis,which can provide reference for the clinical diagnosis and treatment of ischemic stroke patients with ischemic penumbra,and is worthy of clinical promotion and use.