【摘要】 目的 探讨320排CT全脑灌注成像(CTP)在早期急性脑梗死中的临床应用价值。方法 回顾性分析25例早期急性脑梗死的320排CT脑灌注成像资料,对比分析CTP灌注参数(CBF、CBV、MTT、TTP)和其对应灌注伪彩图在脑梗死区、缺血半暗带区(IP)及对应健侧区的变化。结果 25例患者全脑CTP均发现灌注异常区,7例核心梗死区表现为CBF与CBV均较健侧明显下降,MTT较健侧缩短,TTP均较健侧明显延长;18例IP病灶CBF较健侧稍降低,CBV较健侧稍增加或维持正常,MTT及TTP均较健侧延长。脑梗死区与健侧对应区域比较,CBF、CBV、MTT、TTP值均有显著性差异(P<0.01);急性脑梗死IP区与梗死核心区比较,CBF、CBV、MTT及TTP值差异均有明显统计学意义(P<0.01);IP区与健侧对应区比较,CBF、MTT、TTP值差异均具有统计学意义(P<0.05),CBV值差异无统计学意义(P>0.05),但显示血流呈下降的趋势。CTP各参数相对应的伪彩图,可直接、形象地显示脑梗死区域血流的异常变化,尤其MTT图与TTP图对显示异常更清晰、敏感。结论 320排CT全脑灌注成像对急性脑梗死的早期发现和判断是否存在缺血半暗带具有重要的价值。更多还原

【Abstract】 Objective To explore the clinical value of whole-brain CT perfusion imaging with 320-detector row CT in early acute cerebral infarction.Methods The CTP parameters(CBF,CBV,MTT,TTP) and its pseudo color map of 25 patients with early acute cerebral infarction were retrospectively analysed and compared between infarction area,ischemic penumbra(IP) and the contralateral normal region.Results The abnormal perfusion area were found on CTP in 25 patients with early acute cerebral infarction.CTP showed cerebral blood flow(CBF) and cerebral blood volume(CBV) decreased significantly,mean transit time(MTT) shortened significantly,time to peak(TTP) was significantly longer than those of the contralateral normal region in 7 cases of acute cerebral infarct core.18 cases of IP lesions showed CBF decreased slightly,CBV increased slightly or maintain normal,MTT and TTP extension compared with contralateral.CBF,CBV,MTT,TTP values had significantly differences between infarct region and the contralateral corresponding normal region,between the infarct core area and IP of acute cerebral infarction(P<0.01).CBF,MTT,TTP values had statistically significant(P<0.05),and CBV values was not statistically significant(P>0.05) between IP region and the contralateral corresponding normal region,but showed a downward trend in blood flow.Parameter color maps of CTP could directly,clearly and sensitively show abnormal changes region about cerebral blood flow.In particular,MTT and TTP maps shows abnormal region clearer and sensitively.Follow-up 18 cases of IP,active lesions deduced in 6 cases,the lesions disappeared in 5 patients(CT/MRI showed no abnormal,and the clinical symptoms disappeared) after thrombolytic therapy,7 cases of MRI and CT scans confirmed infarction stove.Conclusion Whole-brain CTP with 320-detector row CT can early show the acute cerebral infarction and its ischemic penumbra,it has significant important clinical value for early acute cerebral infarction.更多还原