CTP联合CTA检查诊断急性缺血性脑卒中的价值

Value of CTP combined with CTA in the diagnosis of acute ischemic stroke

目的探讨CTP联合CTA检查诊断急性缺血性脑卒中(AIS)的价值。方法选择2018年6月到2021年6月期间我院收治的疑似AIS 80例为受试者,患者均同时行CT平扫、CTP及CTA检查。记录头颅CT平扫、CTP检查及CTA检查结果,并对比CTP检查AIS患者的梗死区与对侧区的参数,缺血半暗带区与对侧区的参数,缺血半暗带区与梗死区的参数。结果80例受试者经CT平扫可见有40例出现早期低密度病灶,其余40例未见明显异常。CTP检查后72例受试者诊断为AIS,其余8例受试者为短暂性脑缺血发作。针对37例经CTP检查显示缺血半暗带的患者行进一步分析,见梗死区的CBF、CBV低于对侧区,MTT长于对侧区(P<0.05)。缺血半暗带区的CBF低于对侧区,MTT长于对侧区(P<0.05),两区的CBV比较无统计差异(P>0.05)。梗死区的CBF、CBV低于缺血半暗带区,MTT长于缺血半暗带区(P<0.05)。CTA检查后75例受试者诊断为AIS;其余5例未见狭窄现象。结论CTP通过CBF、CBV、MTT等参数能敏感地发现脑血管早期病变,CTA可通过评估患者颈动脉与颅内动脉的狭窄与闭塞,两者联合可用于AIS的诊断。

Objective To investigate the value of CTP combined with CTA in the diagnosis of acute ischemic stroke(AIS).Methods 80 patients with suspected AIS admitted to our hospital from June 2018 to June 2021 were selected as subjects.All patients underwent CT plain scan,CTP and CTA examination at the same time.The results of head CT plain scan,CTP examination and CTA examination were recorded,and the parameters of the infarct area and the contralateral are⁃a,the parameters of the ischemic penumbra area and the contralateral area,and the parameters of the ischemic penumbra ar⁃ea and the infarction area in AIS patients were compared by CTP examination.Results CT plain scan showed that 40 of the 80 subjects had early low⁃density lesions,and the other 40 had no obvious abnormalities.After CTP examination,72 subjects were diagnosed with AIS,and the remaining 8 subjects were diagnosed with transient ischemic attack.Further analysis of 37 patients with ischemic penumbra by CTP examination showed that CBF and CBV of infarction area were lower than that of contralateral area,and MTT was longer than that of contralateral area(P<0.05).The CBF in the ischemic penumbra area was lower than that in the contralateral area,and the MTT was longer than that in the contralateral area(P<0.05).There was no statistical difference in CBV between the two areas(P>0.05).CBF and CBV in infarct area were lower than those in ischemic penumbra area,and MTT was longer than those in ischemic penumbra area(P<0.05).After CTA examination,75 subjects were diagnosed as AIS.No stenosis was found in the other 5 cases.Conclusion CTP can sensitively detect ear⁃ly cerebrovascular lesions through CBF,CBV,MTT and other parameters.CTA can be used for the diagnosis of AIS by eval⁃uating the stenosis and occlusion of carotid artery and intracranial artery in patients.