VCTDSA 联合CT 灌注成像对依达拉奉治疗急性脑梗死的影像学评价.docVIP

VCTDSA联合CT灌注成像对依达拉奉治疗急性脑梗死的影像学评价 魏有东，吕发金，李琦，邹德智，谢鹏 （重庆医科大学附属第一医院神经内科，重庆市神经病学重点实验室，〔400016） 摘要：目的: 探讨VCTDSA联合CT灌注成像对依达拉奉治疗急性脑梗死的影像学评价。方法：将60例临床诊断为急性脑梗死的患者随机分为两组，对照组:给予常规急性脑梗死治疗，治疗组:在对照组基础上加用依达拉奉治疗。两组分别于用药前和用药14天后行VCTDSA联合CT灌注成像,测定相应区域脑血流量(CBF) ,脑血容量(CBV) , 平均通过时间(MTT) 和达峰时间( TTP) 。观察治疗前后患者CT灌注图像变化、VCTDSA图像结果。结果： 60例患者用药前CT 灌注成像表现为CBF 下降、CBV 下降、MTT 延长、TTP延长或无TTP 出现。用药14天后，对照组CT灌注成像表现为CBF、CBV 值升高,TTP、MTT 值缩短。而治疗组改善更加明显。VCTDSA可见51例患者相应责任血管的不同程度的狭窄, 9 例患者未检出相应责任血管狭窄。用药14天后，VCTDSA可见36例患者相应责任血管区侧支循环增加，其中对照组10例，治疗组26例。结论：依达拉奉是一种治疗急性脑梗死疗效显著有效药物。VCTDSA联合CT灌注成像对急性脑梗塞早期诊断及临床用药有重要指导意义。 关键词：容积CT数字减影血管造影；CT灌注成像；依达拉奉；脑梗死 VCTDSA combined with CT perfusion for evaluation of acute cerebral infarction treated with Edaravone Wei You Dong, Lv FaJin,,Li Qi , Zou De Zhi ,Xie Peng Department of Neurology, The First Affiliated Hospital of Chongqing University of Medical Sciences, The key laboratory of Neurology in Chongqing, China 400016 Abstract: Purpose: To evaluate the treatment efficacy of Edaravone in acute cerebral infarction by using combined VCTDSA and CT perfusion. Methods: Sixty patients with clinical diagnosis of acute cerebral infarction were randomly assigned to the treatment group and control group. The control group received routine medical treatment. In the treatment group, Edaravone was added to routine medical treatment. VCTDSA and CT perfusion were used to assess the imaging changes before treatment and 14 days after treatment. The CBF, CBV, MTT, TTP and VCTDSA angiograms were assessed. Results: Before treatment, the CT perfusion showed decreased CBF and CBV, prolonged MTT and TTP. In the control group, there is an increase in CBF and MBV and shortening of TTP and MTT at 14 days after treatment. The improvement was more obvious in the treatment group. VCTDSA showed varying degrees of stenosis in fifty-one patients. Nine patients did not have vascular abnormalities. VCTDSA showed increase of collateral supply in 36 patients at 14 days after treatment. Of these 36 pati