Objective To explore the value of 4D CT angiography and dynamic whole-brain CT perfusion imaging in e-valuating collateral vessels and its influence of brain perfusion and prognosis in ischemic stroke. Methods 34 patients (M 24, F 10; age range 42~84 years, mean 68, 22 years) with ischemic cerebrovascular disease underwent 4D dynamic whole-brain CTA-CTP imaging. 22 patients had follow-up CT or MR imaging 20-40 days after initial scan. CTA-CTP results were compared with follow-up imaging results. Results Among 34 patients, 4D dynamic CTA-CTP imaging was negative in 3 patients and positive in 31 patients, with sensitivity of 96. 88% and specificity of 100%. 29 cases were confirmed to be ischemia stroke. 4D CTA of the stroke patients revealed internal carotid artery (ICA) and/or middle cerebral artery (MCA) occlusion or stenosis in 23 cases. 12 of them with visible collateral vessel formation had small final infarct and better prognosis. Conclusion 4D CTA imaging is a reliable and effect method to determine hemodynamic changes and collateral vessel formation of the ischemic stroke. It provides helpful information for clinical individual treatment.%目的 探讨4D CTA结合全脑容积CTP成像评价脑缺血后侧枝血流对脑灌注状态及预后的意义.方法 34位缺血性脑血管病患者(男24例,女10例,年龄42～84岁,平均年龄68.22岁),接受了全脑动态CTA-CTP成像,22例患者在初次检查后20～40天进行了影像学随诊.动态CTA-CTP结果与随访的影像结果进行比较.结果 34例患者中动态CTA-CTP成像阴性者3例,阳性者31例,诊断的敏感性96.88％,特异性100％.阳性者中29例为缺血性脑卒中患者,4D CTA发现责任血管闭塞或狭窄23例,其中12例患侧可见侧枝血管形成,这12例患者预后良好.结论 4D CTA技术是评价侧枝循环及脑灌注状态的可靠的和有效的方法,有助于临床制定个性化的治疗方案.
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