摘要
目的探讨CT血管成像(CTA)联合CT灌注成像(CTP)在前循环脑梗死中的临床应用价值。方法回顾性分析542例经头MRI DWI证实大脑半球有新发梗死灶的缺血性脑卒中患者资料,所有病例均具备头CTA及CTP检查,分析责任血管病变程度与病灶大小、病灶部位血流灌注异常情况的关系。结果在本组病例中责任血管多见于大脑中动脉(58.6%),其次是颈内动脉颅外段(32.9%)。不同的责任血管病变部位、狭窄程度及其支配区灌注异常情况,其梗死灶的大小均具有显著性差异(P分别为0.015、0.000和0.000),其中以大脑中动脉病变、血管闭塞或中重度以上的狭窄以及灌注程度低的病例梗死灶相对大(>15mm)。但仍有28例(12.6%)责任血管为重度狭窄或闭塞的患者表现为腔隙性脑梗死。此外,337例CTP异常患者中,86例(25.5%)存在低灌注区大于梗死灶。结论本研究显示前循环脑梗死的责任血管多见于大脑中动脉。影像学显示的梗死灶的大小并不完全与血管病变程度一致。此外,约25%患者存在梗死面积与灌注降低不匹配现象。因此,对前循环脑梗死患者进行CTA联合CTP检查,对临床缺血性脑卒中的综合性评估和个体化治疗具有较重要的参考价值。
Objective To evaluate the clinical application of CT Angiography （CTA） and Pertusion （CTP） in the anteri- or circulation infarction after acute cerebral ischemiac. Methods 542 patients of acute ischemic stroke patients who showedwith acute infarction of cerebral hemisphere by head MRI-DWI imaging were analyzed retrospectively, and ＇all cases underwent head CTA and CTP inspection, too. To analyze the correlation of responsible vascular lesions,infarction size and brain perfusion abnor- malities of the anterior circulation infarction. Results In this study ,the most common location of responsible vascular lesions are MCA（58.6% ） and extracranial internal carotid artery（32.9% （. Different location,lesions and perfusion of the responsible vas- cular,exibitsted different infarction size （P = 0. 015 ,0. 000 and 0. 000）. The size of infarctions size caused by middle cerebral ar- tery lesion ,vascular occlusion or severe stenosis and hypoperfusion wereas bigger （more than 15mm）. But the infarction size of 28 cases （ 12.6% ） thatwho exibitsted vascular occlusion or severe stenosis was Lacunar infarction. Abnormal CT perfusion exis- ted in 337 cases. Area of hypoperfusion 86 cases （25.5%） washad area of hypoperfusion bigger than that of infarction size in 86 cases （25.5%）. Conclusion In this study,we find Tthe most common location of responsible vascular lesions in the anterior circulation infarction are MCA. We eouldn＇ t identify the potential severity of vascular lesions through by infarction size through or image,, there were about 25% a quarter of patients whose with infarction size and severity of hypoperfusion were mismatched. The application of CTA and CTP has important reference invalue for comprehensive assessment of ischemia stroke in the anterior circulation infarction.
出处
《中风与神经疾病杂志》
CAS
CSCD
北大核心
2013年第1期56-59,共4页
Journal of Apoplexy and Nervous Diseases
关键词
缺血性脑卒中
前循环脑梗死
CT血管成像
CT灌注成像
Ischemic stroke
Anterior circulation infarction
CT angiography imaging
CT perfusion imaging
