论文部分内容阅读
目的:将短暂性脑缺血发作(TIA)患者与由TIA进展为脑梗死患者急性期的CT灌注结果及临床特点进行对比分析,探讨影响TIA进展为脑梗死的因素。方法:经临床检查确诊TIA患者及由TIA进展为脑梗死患者在急性期先行常规16排螺旋CT横断面平扫,然后根据临床症状及体征,选择拟诊感兴趣平面,行脑CT灌注扫描(CTP)和CT血管造影(CTA)。总结两组患者的发作次数、发作持续时间及危险因素并进行统计学分析。结果:由TIA进展为脑梗死组△rCBF值与发作次数呈正相关,TIA组患者与由TIA进展为脑梗死组患者的CTPI值、发作次数、发作持续时间及危险因素比较差异有显著性。CTA检查显示由TIA进展为脑梗死患者均有与病灶区相关的脑动脉主干或分支的狭窄,而TIA患者中仅有2例患者大脑后动脉有轻度狭窄,且与患者临床表现不相符。结论:TIA进展为脑梗死与△rCBF下降程度、TIA发作次数、发作持续时间及颅内动脉狭窄有密切的关系。对于有多次或发作时间长的TIA患者,应进一步行头颅CTPI和CTA检查,了解颅内脑组织血流灌注情况及有无动脉狭窄,积极治疗以预防缺血性卒中的发生。
Objective: To compare and analyze the CT perfusion and clinical features of patients with transient ischemic attack (TIA) and acute cerebral infarction (TIA) developed from TIA to explore the factors influencing the progression of TIA to cerebral infarction. Methods: TIA patients diagnosed by clinical examination and patients with cerebral infarction progressing from TIA underwent routine 16-slice spiral CT scan in the acute phase. According to the clinical symptoms and signs, the plane of interest was selected and the brain CT perfusion scan CTP) and CT angiography (CTA). Summarize the number of attacks, duration of attack and risk factors in both groups and make statistical analysis. Results: The △ rCBF was positively correlated with the number of seizures in patients with cerebral infarction by TIA. There was significant difference in the CTPI, the number of seizures, the duration of seizure and the risk factors between TIA patients and those with TIA progressing to cerebral infarction. CTA examination showed that patients with cerebral infarction progressing from TIA had stenosis of the trunk or branches of the cerebral arteries associated with the lesion, whereas only two of the TIA patients had mild stenosis of the posterior cerebral artery and were not consistent with the clinical presentation. Conclusion: The progression of TIA is closely related to the decrease of △ rCBF, the number of TIA attacks, the duration of attack and the intracranial arterial stenosis. For patients with multiple or long episodes of TIA, head CTPI and CTA should be further performed to understand the intracranial cerebral blood flow and the presence or absence of arterial stenosis, aggressive treatment to prevent ischemic stroke.