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目的评价CT灌注成像在脑内缺血性疾病的作用。方法对24例缺血性中风发作2小时至2个月的患者及10例开颅术后的患者行常规CT扫描及CT灌注成像,28例进行MRI检查,6例行DSA检查及单光子发射计算机体层成像(singlephotonemisioncomputedtomography,SPECT)。结果34例患者CT平扫共检出30个缺血及梗死灶,CT灌注成像共检出41个病灶,均经随访CT、MRI及SPECT证实。40个病灶表现为最大峰值时间(PT)及平均通过时间(MTT)较对侧延长,相对血流量(RF)明显减低(P<00001)。1个急性起病2周的病灶表现为最大峰值时间及平均通过时间较对侧缩短,相对血流量增高。结论结合常规CT及MRI扫描,CT灌注成像不但有利于显示超急性期缺血性卒中病灶,还可观察Moyamoya病、开颅手术损伤等脑内缺血性病灶的血流灌注变化。
Objective To evaluate the role of CT perfusion imaging in ischemic brain diseases. Methods Twenty-four patients with ischemic stroke onset between 2 hours and 2 months and 10 patients undergoing craniotomy underwent routine CT scan and CT perfusion imaging. Twenty-eight patients underwent MRI examination and DSA examination and single photon emission Computed tomography (SPECT). Results Totally 30 ischemic and infarcted lesions were detected by CT scan in 34 patients. Totally 41 lesions were detected by CT perfusion imaging, all of which were confirmed by CT, MRI and SPECT. Forty lesions showed prolonged peak time (PT) and mean transit time (MTT) compared with the contralateral side, and relative blood flow (RF) decreased significantly (P <00001). Acute onset of 2 weeks of lesions showed the maximum peak time and the average passage time shorter than the contralateral, relative blood flow increased. Conclusion Combined CT and MRI scan, CT perfusion imaging is not only helpful for displaying hyperacute ischemic stroke, but also for changes of perfusion in ischemic brain lesions such as Moyamoya disease and craniotomy.