论文部分内容阅读
目的探讨CT灌注成像(CTP)对缺血性卒中急性期的诊断价值,并观察影像学检查与临床的相关性。方法31例急性半球梗死者在发病24h内行头颅CT和CTP检查,同时进行美国国立卫生院神经功能缺损评分(NIHSS),其中18例在发病后12～72h内行头颅MRI+弥散成像(DWI),25例于发病后14～80d复查CT,同时进行NIHSS评分。结果24h内CT和CTP诊断敏感度分别为25.8%和90.3%,6h内CTP诊断敏感度88.2%。DWI上高信号的范围与局部脑血容量(CBV)的缺损程度间有相关关系;最初NIHSS评分与灌注缺损面积及灌注缺损程度无相关关系,而最终NIHSS评分与DWI异常面积和梗死面积有相关关系。结论CTP对超早期半球缺血有诊断价值,能发现缺血半暗带,可成为急性半球缺血的常规检查。最终的神经功能缺损与DWI异常面积和最后梗死面积相关。
Objective To investigate the diagnostic value of CT perfusion imaging (CTP) in the acute phase of ischemic stroke and to observe the correlation between imaging and clinical features. Methods Thirty-one patients with acute hemispheric infarction underwent cranial CT and CTP examinations within 24h of onset. Neurological deficit scores (NIHSS) of the National Institutes of Health were measured simultaneously. Among them, 18 patients underwent MRI and diffusion imaging (DWI) within 12 to 72 hours after onset. Cases of 14 to 80d after onset of CT review, while NIHSS score. Results The diagnostic sensitivity of CT and CTP in 24 h were 25.8% and 90.3%, respectively, and the diagnostic sensitivity of CTP in 6 h was 88.2%. There was a correlation between the extent of high signal on DWI and the extent of regional cerebral blood volume (CBV). The initial NIHSS score had no correlation with perfusion defect area and perfusion defect, but the final NIHSS score was correlated with DWI abnormal area and infarct size relationship. Conclusions CTP has diagnostic value in the early stage of hemispheric ischemia, can be found in ischemic penumbra, can become a routine examination of acute hemispheric ischemia. The final neurological deficit was related to the area of abnormal DWI and the final infarct size.