早期缺血性脑梗死的ct灌注及血管成像.docxVIP

早期缺血性脑梗死的CT灌注及血管 成像 【摘要】 目的：探讨多层螺旋CT颈内 动脉血管成像(MSCTA及脑灌注成像 (MSCTPI)对早期缺血性脑梗死的应用价值。 方法：对24例经临床证实的早期脑梗死患者 行MSCTP及MSCTA^查。通过灌注分析软 件生成局部脑血流量、局部脑血容量及平均 通过时间三种参数的函数图像。 MSCTA勺扫 描数据运用多平面重建及最大密度投影技 术重建颈内动脉。结果:24例患者中，1例 MSCTP检查表现为过度灌注，5例表现为延 迟灌注，16例表现为不同程度的灌注不足， 2例灌注正常。MSCT艘现24例患者48支 颈内动脉中，40支有动脉管壁钙化斑块，37 支颈内动脉可见到软斑块。其中 32支颈内 动脉呈不同程度的狭窄，5支颈内动脉闭塞， 11支血管无狭窄。22例在常规CT及MRI图 像上为中及大体积梗死的患者， MSCTP I发现 与梗死灶相对应的异常灌注区，且均比常规 CT及MRI图像上病灶体积大，MSCTA1示 颈内动脉呈中重度狭窄或闭塞。 2例未发现 明显灌注异常的患者，为小体积梗死灶， MSCT扉示颈内动脉正常。结论：MSCTPI联 合MSCT何诊断早期缺血性脑梗死，并评价 其血液灌注情况，同时还可客观评价缺血区 颈内动脉的状况。 【关键词】脑梗死体层摄影术X线计算机 成三维 Abstract: Objective:To explore the applied value of multislice computed tomographic perfusion imaging(MSCTPI) and computed tomographic angiography (MSCTA) in early ischemic cerebral infarction. Methods： MSCTPI and MSCTA was performed in 24 patients who initiailly diagnosed as acute cerebral infarction by clinic in 72 hours. Regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV) and mean transit time (MTT) acquired by the post MSCTA of internal carotid artery was performed and images including source axial images and reconstructed images by maximum intensity projection( MIP) and multi-planar reconstrution (MPR) methods were also analyzed. Results: Of all 24 cases, one case appeared hyperfusion, 5 cases showed delayed perfusion, 16 cases appeared variant hypoperfusion, and 2 cases had negative results. MSCTA could detect calcific plaque in 40 internal carotid arteries and soft plaque in 37 internal carotid arteries. Stenosis of internal caroid antery was found in 32 of 48 branches in 24 case. 5 branches were occlusive and 11 branches were normal. 22 cases with large or moderate cerebral infarction volume confirmed by CT and MRI were smaller than those on MSCTPI as having abnormal perfusion lesions , which were moderate and obvious stenosis and occlusion on MSCTA.In 2 cases with small cerebral infarction volume, MSCTPI and MSCTA revealed normal. Conclusion: The combination of MSCTPI and MSCTA