【摘要】 目的探讨CT灌注成像在脑缺血半暗带评估中的应用价值。方法共43例伴有急性脑血管意外症状和体征的患者,男27例,女16例,年龄50~71岁(平均58.5岁),起病至就诊时间约为2.5~13.5 h。行头部常规CT检查后,立即做CT灌注成像检查,使用CT Perfusion软件分别计算出CBF、CBV、MTT及镜像区CBF、CBV的比值rCBF、rCBV(患侧/健侧),最后应用统计学软件对数据进行分析。结果所有患者在CT灌注参数图像能够明确显示出病灶区,表现为病灶区MTT延长和CBF的下降。患侧半球缺血中心区的CBF、CBV、MTT分别为(24.8±9.6)m l/100 g/m in,(3.3±0.86)m l/100 g,(7.1±2.2)s;缺血边缘区的CBF、CBV、MTT分别为(38.6±10.3)m l/100 g/m in,(3.4±0.91)m l/100 g,(6.4±1.3)s;正常区的CBF、CBV、MTT分别为(48.8±11.2)m l/100 g/m in,(3.7±1.1)m l/100 g,(3.5±1.9)s。缺血坏死区和半暗带区的rCBF分别为0.35±0.16,0.53±0.13,P<0.05。rCBV分别为0.61±0.18,0.81±0.15,Ρ>0.05。结论脑CT灌注成像能很好地评价脑血流动力学改变,准确显示缺血脑组织的部位和范围,计算出多种参数图像及缺血半暗带阈值,为指导临床溶栓治疗提供依据。更多还原

【Abstract】 Objective To evaluate the applied value of ischemic penumbra of brain by CT perfusion.Methods 43 patients withsymptoms of acute stroke onset between 2.5 and 13.5 h underwent CT perfusion scans immediately after plain CT scan in interested section.The mean values of CBF,CBV,and MTT at the areas of infarction,the marginal zone of infarction and normal zone were calculated.Therelative perfusion parameters(rCBF,rCBV) were assessed semiquantitatively by using the results from mirrored regions within thecontralateral hemisphere as reference.For the CBF and CBV,the ratio of the affected brain tissue to the normally perfused contralateralhemisphere was calculated.Standard descriptive statistics such as mean ±SD values of rCBF,rCBV derived from the infarcted andnoninfarcted brain were calculated.The efficiency of each parameter to predict tissue outcome was tested.Results All 43 cases,ischemic lesions were found on CT perfusion parameter image,thire parametric image showed the lesions hypoperfusion,the lesions itself showed MTT delay,CBF decrease.For CBF,CBV,MMT,the mean values of infarction core were(24.8±9.6)ml/100g/min,(3.3±0.86)ml/100g and(7.1±2.2)s respectively;The mean values of marginal zone of infarction were(38.6±10.3)ml/100g/min,(3.4±0.91) ml/100g,(6.4±1.3) s respectively and normal zone were(48.8±11.2)ml/100g/min,(3.7±1.1)ml/100g,(3.5±1.9)s respectively.The mean values of rCBF of infarction and noninfarction were 0.35±0.16 ,0.53±0.13,(P<0.05) and 0.61±0.18,0.81±0.15,(P>0.05) respectively for rCBV of infarction and noninfarction.Conclusion Perfusion CT of brain is potentially useful for detecting cerebral perfusion deficits in acute ischemic stroke before morphologic changes and providing valuable information to predict tissue outcome.更多还原