CT Perfusion Imaging Predicts One-Month Outcome in Patients with Acute Spontaneous Hypertensive Intracerebral Hemorrhage

Purpose: Little is known about the relationship between perihematomal perfusion parameters in acute spontaneous hypertensive intracerebral hemorrhage patients and recent outcome. The purpose of this study was to evaluate the relationship between the perfusion parameters of the perihematomal brain tissue and the recent prognosis of patients with acute spontaneous hypertensive intracerebral hemorrhage (shICH) using CT perfusion (CTP) imaging. Methods: Twenty-six patients with clinical and CT diagnosed supratentorial shICH received CTP scanning within 8 - 19 h after symptom onset. At the maximum levels of the hematoma, cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) of perihematomal area (isodense within 1cm rim of perilesion area on plain CT) and contralateral mirrored hemisphere were measured, and rCBF, rCBV, rMTT were calculated (ipsilateral/contralateral). The one-month follow-up in accordance with daily living table (Barthel index, BI) by telephone was recorded. Results: The CBV, CBF, and MTT values of perihematoma area were (1.61 ± 1.53) ml·100 g-1, (16.48 ± 12.58) ml·100 g-1·min-1, and (9.12 ± 2.57) s, respectively. (For more information,please refer to the PDF)

Cerebral artery evaluation of dual energy CT angiography with dual source CT

Background Conventional computed tomography angiography （CTA） is time consuming, user-dependent and has poor image quality in skull base region. This study assessed the feasibility of a new method, dual energy CTA for depicting the cerebral artery.Methods Phantom scan was done with head CTA sequences on dual source CT and 64 spiral CT for radiation dose calculation. Dual energy CTA was done with dual source CT on 36 patients who were suspected of having cerebral vascular disease. Three series axial images in 0.75 mm thick, 0.4 mm increment were acquired, which were named with 80 kV, 140 kV and merged images; 80 kV and 140 kV images were transferred into dual energy software, and maximum intensity projection （MIP） image was generated quickly by dual energy bone remove （DEBR group）; merged images were transferred into In Space software to acquire MIP image through manual conventional bone remove （CoBR group）. Post processing time and reading time were compared. Image qualities of the two groups were compared, mainly focusing on skull base segments of internal carotid artery and bone subtraction. ANOVA and SNK tests were applied for radiation dose comparison. Student＇s t test and Wilcoxon rank sum test were applied for assessing differences between data for significance. Cohen＇s kappa was used for interobserver agreement. Results Radiation dose of phantom scan showed dual energy CTA was between digital bone subtraction and conventional CTA. The post processing time and reading time were much shorter in DEBR than CoBR, and image quality in skull base was much higher in DEBR than CoBR （P〈0.01）. There was no significant difference for suprasellar vessels between two groups （P〉0.5）. Interobserver agreement for all vessel segments was excellent （kappa=0.97）. Conclusions Dual energy CTA is a reliable, new modality for depicting cerebral artery, overcoming the limitation of conventional CTA in the skull base region. It can save much time in post processing and reading than conventional CTA.

消化道的现代放射学检查

国际知名专家、美国加州大学放射学教授Ａｌｅｘａｎｄｅｒ Ｒ。Ｍａｒｇｕｌｉｓ于今年５月率团到武汉讲学，对消化道影像检查的现状和将来发展作了精辟的、全面的论述，本刊征得有关方面同意，将其讲稿译出以飨读者。

脑型肺吸虫病的CT诊断

探讨脑型肺吸虫病的ＣＴ特征，评价ＣＴ对该病的诊断价值。材料与方法：３０例诊断明确的脑型肺吸虫病。均作颅脑常视ＣＴ扫描，２１例加作增强扫描，回顾性分析其ＣＴ表现。结果：单发１９例，多发１１例，左侧及顶叶发病数量占优势。可分为浸润型、脓肿型、囊肿型、瘢痕型。平均病程自浸润型至瘢痕型逐渐加长。结论：脑型肺吸虫病的ＣＴ表现与其病理变化一致，ＣＴ检查对其诊断和疗效观察具有重要价值。