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目的探讨64层螺旋CT脑灌注成像在急性脑缺血性疾病中的诊断价值。材料与方法20例急性脑缺血性疾病的患者行64层螺旋头颅CT平扫、CT脑灌注成像(CT perfusion,CTP)检查,将CT平扫图像与CTP图像及各参数比较,同时梗死区与周围半暗带及健侧各CTP参数比较。结果首次头颅CT平扫发现脑梗塞病灶12例,复查头颅CT检出腔隙性脑梗塞2例;CTP发现18例病灶,2例腔隙性脑梗塞CTP未见异常。在灌注异常的CTP图像中,测定病灶中央、周围区及健侧的脑血流量(CBF)、脑血容量(CBV)、对比剂平均通过时间(MTT)及达峰时间(TTP),病灶中央与周围区、病灶与健侧对比差异有统计学意义(P<0.05)。结论64层螺旋CT脑灌注成像能提高急性脑缺血性疾病病灶的检出率。分析CTP各参数可区分脑梗死区及缺血半暗带,有助于临床对治疗方案的选择及对预后的判断。
Objective To investigate the diagnostic value of 64-slice spiral CT perfusion imaging in acute cerebral ischemic disease. Materials and Methods Twenty patients with acute cerebral ischemic disease were examined by 64-slice spiral CT scan and CT perfusion (CTP). CT scan images were compared with CTP images and parameters and infarct size With the surrounding penumbra and contralateral CTP parameters comparison. Results In the first CT scan, 12 cases of cerebral infarction were found, 2 cases of lacunar infarction were detected by CT scan, 18 cases were found by CTP, and 2 cases of lacunar infarction were not abnormal. In perfusion CTP images, CBF, CBV, TTP and TTP were measured in the central, peripheral, and contralateral side of the lesion, Compared with the surrounding area, lesion and contralateral side, the difference was statistically significant (P <0.05). Conclusion 64-slice spiral CT perfusion imaging can improve the detection rate of acute cerebral ischemic lesions. Analysis of CTP parameters can distinguish between cerebral infarction and ischemic penumbra, to help clinical choice of treatment options and prognosis.