| 64层 CT 脑 CTP 联合头颈 CTA 对缺血性脑卒中早期诊断的临床应用研究? |
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| 引用本文： | 梁立华,林景兴,陈志军,陈耀强,吴菊芳.64层 CT 脑 CTP 联合头颈 CTA 对缺血性脑卒中早期诊断的临床应用研究?[J].CT理论与应用研究,2016(4):453-461. |
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| 作者姓名： | 梁立华 林景兴 陈志军 陈耀强 吴菊芳 |
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| 作者单位： | 深圳市第四人民医院 福田区人民医院,广东 深圳,518000 |
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| 基金项目： | 深圳市福田区卫生公益性科研项目(FTWS201330)。 |
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| 摘 要： | 目的：探讨64层螺旋 CT 脑 CTP 联合头颈 CTA 对缺血性脑卒中早期诊断的临床应用价值。方法：收集50例拟诊急性脑梗死患者，均于急性发作12 h 内完成 CTA 及 CTP 检查，并及时行相关临床治疗，30 d 后复查头颅 CT 或 MRI 平扫。结果梗死区 CBF、CBV 与对侧相应区差异有统计学意义（P <0.01），半暗带区 CBF、TTP 与对侧相应区差异有统计学意义（P <0.01），CBV 差异无统计学意义（P >0.05）。CTP 诊断半暗带，与复查结果比较，差异无统计学意义（P >0.05），敏感度为95％，特异性为69％；斑块最多见于颈动脉叉（21％）、颈内动脉颅内段（17％）及大脑中动脉（19％），52％为易损斑块。大脑前循环 CTP 异常同侧供血动脉的狭窄程度与对侧相比，差异有显著统计学意义（P =0.005），同侧供血动脉的斑块类型及易损斑块与对侧相比，差异有显著统计学意义（P <0.001）。结论：CTP 能够快速直观区分梗死区与半暗带，以“CBV-TTP不匹配，且 delayTTP >6 s”方法诊断半暗带准确性较高，大脑供血动脉中度以上狭窄、软斑块、混合斑块以及易损斑块等与脑缺血呈明显正相关，CTP 联合 CTA 对急性脑卒中有很高应用价值。
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| 关 键 词： | 64 层螺旋 CT CT 灌注成像 CT 血管成像 急性缺血性脑卒中 |
Clinical Utility Study of CT Perfusion and CT Angiography with 64-Slice Multi-CT for Acute Ischemic Brain Stroke |
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| LIANG Li-hua,LIN Jing-xing,CHEN Zhi-jun,CHEN Yao-qiang,WU Ju-fang.Clinical Utility Study of CT Perfusion and CT Angiography with 64-Slice Multi-CT for Acute Ischemic Brain Stroke[J].Computerized Tomography Theory and Applications,2016(4):453-461. |
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| Authors: | LIANG Li-hua LIN Jing-xing CHEN Zhi-jun CHEN Yao-qiang WU Ju-fang |
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| Abstract: | Objective: To study the clinical applicative value of brain CT perfusion joint head and neck CT angiography with 64-slice multi-detectors CT for acute ischemic brain stroke. Methods: 50 cases of maybe acute cerebral infarction patients were collected to CTA and CTP examination within 12 hours after onset, and related clinical treatment in time. Head CT or MRI review were took 30 days later. Results: CBF, CBV of Infarct and contralateral corresponding area was significantly statistically different (P < 0.01), CBF, TTP of penumbra and contralateral corresponding area was significantly statistically different (P < 0.01), but CBV with no statistically significantly difference (P > 0.05). CTP diagnosis penumbra, compared with the results of the review, the difference was not statistically significant (P > 0.05), with a sensitivity of 95% and a specificity of 69%. Most plaque were found in the carotid bifurcation (21%), intracranial internal carotid artery (17% ) and middle cerebral artery (19%), 52% of vulnerable plaque. Compared the stenosis between ipsilateral and contralateral feeding artery in patients with anterior circulation CTP abnormalities, the difference was statistically significant (P = 0.005), the difference of plaque type and vulnerable plaque was statistically significant (P < 0.001). Conclusions: CTP can visually distinguish infarct and penumbra. Higher accuracy was found with method "CBV-TTP does not match, and delay TTP > 6 s" to diagnose penumbra, Moderate or more stenosis, soft plaques, mixed plaques and vulnerable plaques in feeding artery were positively correlated with stroke. CTP and CTA have a high application value for acute ischemic brain stroke. |
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| Keywords: | 64 layer spiral CT CT perfusion imaging CT angiography acute ischemic stroke |
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