256排螺旋CT头颈部血管造影与脑灌注在急性脑梗死的诊断价值

256 Slice Spiral CT Head and Neck Angiography with Cerebral Perfusion in Acute Cerebral Infarction

目的:探究256排螺旋CT脑灌注与血管造影在急性脑梗死中的临床应用价值。方法:选取2022年2月~2023年10月在本院治疗的急性脑梗死患者65例为研究对象,分别给予所有患者CT脑灌注、血管造影检查,对比分析梗死区及健侧参数。结果:65例患者经常规CT扫描后39例显示存在早期脑梗死征象,占比为60.00%,其余则显示无灌注异常,CT脑灌注显示,梗死区脑血容量(42.85±11.20)mL/(100g·min)及脑血流量(1.98±0.73)mL/100g均明显低于健侧区(56.02±12.87)mL/(100g·min)、(2.43±0.86)mL/100g(P<0.05),梗死区对比剂峰值时间(45.17±10.96)s和平均通过时间(26.47±2.08)s明显高于健侧区(22.51±7.23)s、(4.01±1.52)(P<0.05)。血管造影结果显示,本组65例患者中一侧颈内动脉狭窄35例,一侧大脑中动脉狭窄15例,一侧颈动脉闭塞5例,一侧大脑中动脉闭塞10例。结论:在对急性脑梗死患者进行诊断时,血管造影剂CT灌注均具有一定优势,两者联合应用可提高急性脑梗死诊断准确率,为进一步治疗提供有利依据。

Objective:To explore the clinical application value of CT cerebral perfusion and angiography in acute cerebral infarction.Methods:65 patients with acute cerebral infarction treated in our hospital from February 2022 to October 2023 were selected as the study subjects.All patients received CT cerebral perfusion and angiography,respectively,compare and analyze the parameters of the infarcted area and the healthy side.Results:In 65 patients,39 patients showed signs of early cerebral infarction,at 60.00%,the rest showed no perfusion abnormalities,CT cerebral perfusion showed,CBV in the infarct area(42.85±11.20)mL/(100g·min)and CBF(1.98±0.73)mL/100g were significantly lower than the healthy area(56.02±12.87)mL/(100g·min),(2.43±0.86)mL/100g(P<0.05),TTP(45.17±10.96)s and MTT(26.47±2.08)s in the infarct zone were significantly higher than in the healthy block(22.51±7.23)s,(4.01±1.52)(P<0.05).Angiographic results showed that the 65 patients in this group had 35 internal carotid artery stenosis,15 middle cerebral artery stenosis,5 carotid artery occlusion in one carotid artery and 10 occlusion in one side.Conclusion:CT perfusion has some advantages in the diagnosis can improve the diagnostic accuracy of acute cerebral infarction and provide favorable basis for further treatment.