双源CT容积脑灌注在急性脑梗死诊断中的应用价值

Application of volume perfusion CT imaging in diagnosis of acute ischemic stroke with dual-source CT

摘要:

目的  探讨双源CT容积脑灌注成像（VPCT）在急性脑梗死的诊断价值。方法  对27例临床拟诊为急性脑梗死患者，于发病4～72h内行颅脑CT平扫和VPCT，获得三维VPCT参数图：脑血流量（CBF）、脑血容量（CBV）、排空时间（TTD）及平均通过时间（MTT），并重建颅脑4D-CTA；于VPCT检查后48 h内复查MRI DWI，分析VPCT、4D-CTA及MRI DWI表现。结果  27例患者VPCT发现与临床症状相对应低灌注区70处，MR DWI表现为梗死灶53处；14处梗死灶4D-CTA显示相应责任血管病变。结论  双源CT容积脑灌注可同时获得VPCT和4D-CTA图像，为急性脑梗死临床治疗、预后评估提供参考。

Abstract:

Objective To explore the application of volume perfusion CT (VPCT) imaging with dual-source CT in diagnosis of acute cerebral ischemic stroke. Methods Twenty-seven cases with clinically suspected acute ischemic stroke underwent plain CT and VPCT within 4-72 h after the onset of symptoms. The parameter map of cerebral blood flow (CBF), cerebral blood volume (CBV), time to drain (TTD) and mean transit time (MTT) were analyzed. Meanwhile dynamic CT angiography (4D-CTA) images were obtained. MRI DWI was performed within 48 h after VPCT. Results VPCT showed 70 hypoperfusion areas corresponding to clinical symptoms in the 27 patients. MRI DWI confirmed that 53 lesions were infarct foci. And 4D-CTA showed vascular lesions in 14 patients. Conclusions Dual-source CT can obtain VPCT and 4D-CTA images at the same time, which provides the reference for clinical treatment and prognosis evaluation.