摘要
目的探讨CT脑灌注与血管造影在急性脑梗死中的临床应用效果。方法急性脑梗死患者中抽取69例为研究对象,对其分别实施CT脑灌注与血管造影检测,分析平扫及灌注成像表现,对比缺血区与脑血流参数与其对侧相应区域灌注参数,进行脑内动脉、颈段血管造影图像的重建。结果 (1)经头颅平扫显示有早期脑梗死征象者41例,无灌注异常区域28例。经CT脑灌注成像检查显示,患者脑梗死区的血流量、脑血容量均明显低于对侧镜像区,其中梗死区域对侧镜像区的血流量对比差异均有统计学意义(P<0.01),而脑血容量对比差异无统计学意义(P>0.05);(2)脑梗死区对比剂峰值时间与对比剂平均通过时间均明显长于对侧镜像区(均P<0.01);(3)患者的血管造影图重建结果显示,单侧颈内动脉狭窄37例,单侧大脑动脉狭窄16例,左侧大脑动脉闭塞11例,左侧颈内动脉闭塞5例。结论 CT脑灌注可准确并及时反应患者脑部缺血程度、缺血位置,并预测其半暗带,而脑部血管造影可反映其病变血管位置、病变程度,联合应用CT脑灌注与血管造影检测法有助于早期、准确诊断急性脑梗死。
Objective To investigate the clinical application of CT perfusion and angiography in acute cerebral infarction. Methods A total of 69 patients with acute cerebral infarction were enrolled in the hospital from May 2015 to June 2016,and treated with CT perfusion and angiography detection respectively,plain and perfusion imaging performance were analyzed. Ischemic area and cerebral blood flow parameters and its contralateral corresponding regional perfusion parameters were also compared, and reconstruction of intracraniai arterial and cervical angiographic images were analyzed. Results （1） Among the 69 patients with a- cute cerebral infarction, skull plain showed that 41 cases had signs of early cerebral infarction, and the other 28 cases had no abnor- mal perfusion area. CT perfusion imaging showed that the blood flow and cerebral blood volume in the cerebral infarction area were significantly lower than those in the contralateral imaging area, and the difference of blood flow in the contraiateral area was statis- tically significant （P^0. 01）, and the difference of cerebral blood volume was not statistically significant （P^0. 05）. （2） The peak time of the contrast agent and the average passage time of the contrast agent in the cerebral infarction area were significantly longer than those in the contralateral imaging area （P^0.01）. （3） Angiography reconstruction results showed that 37 patients with unilateral internal carotid artery stenosis, 16 patients with unilateral cerebral artery stenosis, 11 patients with left cerebral ar- tery occlusion and 5 patients with left internal carotid artery occlusion. Conclusion CT perfusion can accurately and timely respond to the degree of cerebral ischemia and ischemic position of the patients,and predict the penumbra;CTA can discern the abnormal blood supply artery and the location effectively, then provide important indicators for acute cerebral infarction patients. CT brain perfusion combined with blood vessels angiographic method is helpful for the early and accurate diagnosis of acute cerebral infarction.
出处
《中国实用神经疾病杂志》
2018年第2期173-176,共4页
Chinese Journal of Practical Nervous Diseases
