课件：C灌注成像.ppt

In the calculation of relative perfusion indices from CBF values in ischemic areas and in mirrorred ROIs within the unaffected hemisphere proved to be a valuable method for the prognostic evaluation of a region with reduced perfusion. The core of the infarct and the ischemic marginal zones demonstrate clearly different CBF perfusion indices (green-marked ROI = 0.17 versus red-marked ROI = 0.69 ). The findings of perfusion CT could be verified by DSA with regard to the type of occlusion and the condition of the collateral blood supply . The follow-up CT after a successful intra-arterial fibrinolysis shows the infarct in dimensions comparable to the infarct core seen with perfusion CT. 70 minutes after the occurrence of the infarction, the CBF image revealed a highgrade ischemia in the frontal region of the supply area of the MCA and in the lentiform nucleus (Fig. 3a) with a perfusion index in the greenmarked ROI of 0.07 (Fig. 3b). As a result of the good collateral flow, the disturbance in perfusion in the remaining region of the MCA, with a perfusion index of 0.82, is not seen to be very extensive (red-marked ROI in Fig. 3b). 36-year-old male patient with an embolic occlusion in the M1 segment of the left MCA and a simultaneous occlusion of the left internal carotid artery as a result of dissection. Case 3 Because of the partially high-grade ischemia on the one hand and the excellent collateral blood supply of the marginal region on the other, fibrinolysis was not performed in spite of the short time interval. As expected, the follow-up CT revealed the development of an infarction in the area which had primarily demonstrated a high-grade ischemia. 灌注CT与颅脑CT扫描和颅脑CT血管造影术结合为脑梗塞早期检查提供了一种有用工具。 常规CT可检查梗塞区域的形成 灌注CT可决定局部缺血的区域，提供了局部缺血组织的位置和潜在病变区域 CT血管造影术为诊断提供了相应病灶区域的形态。 为临床工作人员决定进一步治疗的方案提供了重要信息。 CT Perfusion前景 目前认为中风处理的最佳时间在60分钟。通过对造影剂注入位置与方式的研究，灌注CT在不到15分钟中完成中风评价过程。 In the course of an investigation performed on 33 patients, an attempt was made to carry