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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.