64排CT全脑灌注成像在急性脑梗死早诊断价值的初步探讨

摘要

目的 探讨64排CT全脑灌注成像(CTP)在急性期脑梗死早期诊断中的应用价值.方法 使用Philips公司生产的Brilliance64排螺旋CT机对21例发病6 h或12 h内的急性期脑梗死患者进行CT平扫及CTP检查,分析比较平扫及灌注成像表现,测量病变区与对侧相应区域的脑灌注参数值.结果 21例患者中,CT平扫5例显示局部脑沟较对侧变窄、脑实质密度稍微降低等可疑早期脑梗死征象,4例有陈旧腔隙性脑梗死,11例未发现异常征象.CTP检查21例患者均发现脑灌注异常,其中5例患者发现2处异常,4例发现3处异常.CTP表现为脑血流量及脑血容量减低,达峰时间延迟.结论 CTP能够早期、快速显示脑缺血的部位及程度.预测缺血半暗带;对急性脑梗死的早期诊断和指导治疗有重要的临床价值.%Objective To evaluate the application of 64 multi -slice spiral CT cerebral perfusion imaging (CTP) in patients with hyperacute stroke. Methods Conventional cerebral plain CT and CTP were performed in 21 patients with hyperacute ischemic stroke within 6 - 12 hours of onset of symptom. All cases were reexamined by cerebral plain CT after 2 to 12 days. Dynamic CTP images were processed with the" CT Perfusion" software package on workstation. Quantitative analysis of cerebral perfusion parmneters were performed on CTP images. Results Conventional plain CT of the 21 cases found no abnormality in 11 cases and early infarction signs in 5 cases. However, abnormal perfusion changes were found in all 21cases, including decrease in cerebral blood flow(CBF) and cerebral blood volume(CBV), delayed time to peal((TTP). There were significant differences of CBF,CBV and TIP between infarction side and contralateral side(P < 0.01). Conclusion CTP can early show the ischemic extent and penumbra in patients with hyperacute stroke.