超急性期脑梗塞常规CT检查与CT灌注成像的比较研究

Comparing study on conventional CT and CT perfusion imaging in hyperacute cerebral infarction

目的 :探讨常规 CT与 CT灌注成像对超急性期脑梗塞的诊断应用价值。方法 :对 96例临床诊断超急性期脑梗塞的病人行常规 CT头颅平扫及 CT脑灌注成像。在常规轴面扫描后一般选取基底节层面 ,经肘静脉灌注对比剂 ,同时开始持续4 6 S的单层连续动态扫描 ,重建 4 6幅动态图像使用 CT脑灌注软件包进行处理 ,获得灌注成像。计算最大峰值时间 (PT) ,平均通过时间 (MTT)和相对血流量 (RF)。结果 :早期常规 CT头颅平扫 ,显示大脑中动脉高密度征 ,脑实质低密度征等共 35例 ,占36 .4 %。 CT灌注成像发现 88例与临床症状相对应的灌注异常区 ,表现为达峰时间延长 ,另外 8例未发现灌注异常区。结论 :常规 CT对超急性期脑梗塞的诊断 ,具有一定价值 ,但作用有限 ,在准确性远不能满足临床应用的需要。脑 CT灌注成像已成为早期诊断超急性期缺血性脑血管病和指导临床治疗 (尤其是溶栓治疗 )

Objective:To discuss the diagnostic value of conventional CT and CT perfusion imaging in hyperacute cerebral infarction Methods:Conventioal CT and CT cerebral perfusion imaging were performed in 96 patients with clinical diagnosed hyperacute cerebral infarction.After regular CT examination,dynamic scans of 46 seconds were performed on selected slice(usually on the basal ganglia slice)while 46 ml nonionic contrast material were injected through antecubital vein.These dynamic images were processed with the'perfusion CT'software package on a PC basded workstation.PT?MTT and RF were measured within specific regions of the brain.On CT perfusion images quantitative analysis was performed for these images Results:Early conventional non contrast enhanced CT showed hyperdense middle cerebral artery sign(HMCAS)and parenchymal hypodlensity etc.in 35 cases.In 96 cases with hyperacute cerebral infarction,persisting abnormal perfusion changes corresponding to clinical symptoms were found in 88 cases with prolonged TP.Otber 8 cases showed normal results Conclusion:The conventional CT diagnosis for hyperacute cerebral infarction have difinitive value,but its value is limited in acouracy.CT perfusion imaging not only is useful in demonstracting the hyperacute ischemic stroke,but also can provide valuable hemodynamic information and shows the extent of perfusion disturbaces for patient