目的探讨多层螺旋CT全脑血管灌注成像在超急性脑梗死缺血半暗带及部位的判断中临床应用价值。方法对60例超急性脑梗死疑似患者,在患者发病后6h行缺血部位的多层螺旋CT平扫和灌注成像与CTA成像诊断造影观察,并分析灌注图像与CTA的重建后处理图像,所有患者在发病1周后再次行多层螺旋CT复查。结果 15例患者经普通CT扫描发现可疑脑缺血区,45例患者未发现明显异常;所有疑似病例患者均继续行多层螺旋CT全脑血管灌注成像,通过将采集到的脑血管灌注图进行分析,被发现脑组织缺血的部位与患者的临床症状相对应;并通过多层螺旋CTA检查,发现患者大脑中动脉闭塞13例,7例大脑中动脉狭窄,4例颈内动脉狭窄。结论多层螺旋CT全脑血管灌注成像对临床诊断超急性脑梗死具有良好的特异性和敏感性,可以早期发现患者脑组织中存在的缺血半暗带并为患者预后情况的评估起着极其重要的作用价值;多层螺旋CTA检查可以较及时的发现缺血性病变的原因,为进一步临床治疗方案的制定提供了有力的理论依据。 Objective To investigate the clinical value of multi-slice spiral CT perfusion imaging in judging ischemic penumbra and its location in patients with hyperacute cerebral infarction. Methods Sixty patients with suspected hyperacute cerebral infarction were examined by multi-slice spiral CT scan and perfusion imaging at 6h after the onset of the disease and diagnostic imaging by CTA imaging. The reconstructed postprocessing images of perfusion images and CTA were analyzed. Patients were re-examined by multi-slice spiral CT one week after onset. Results Fifteen patients were found to have suspicious cerebral ischemia by ordinary CT scan, and no obvious abnormality was found in 45 patients. All suspected cases were followed up by multi-slice spiral CT perfusion imaging. Cerebrovascular perfusion maps were collected Analysis found that the ischemic brain tissue was found to correspond with the clinical symptoms of the patients. In the multi-slice CTA examination, 13 cases of middle cerebral artery occlusion, 7 cases of middle cerebral artery stenosis and 4 cases of internal carotid artery stenosis were found. Conclusions Multi-slice spiral CT perfusion imaging has good specificity and sensitivity for clinical diagnosis of hyperacute cerebral infarction. It can detect the ischemic penumbra present in brain tissue early and plays an important role in the assessment of prognosis Important role of value; multi-slice spiral CTA examination can be more timely detection of the cause of ischemic lesions for the further development of clinical treatment programs provide a strong theoretical basis.