文档介绍：早期急性缺血性脑卒中16排螺旋CT灌注成像应用研究
作者:韩献军沈霞崔桂云徐凯杨春
【关键词】卒中
摘要:目的研究早期急性缺血性脑卒中16排螺旋CT灌注成像(CTPI)应用价值。方法对45例早期急性缺血性脑卒中(发病时间≤24h)应用16排螺旋CT依次进行头颅CT平扫与CTPI检查。结果 CT平扫:%,%。CTPI:%,特异度100%。四格表χ 2 检验证明CTPI较CT平扫检出脑内缺血病灶更敏感(χ 2 =,P=<)。CTPI的rCBF、rCBV、rMTT、rTTP和rPE的95%置信区间(95%CI):缺血半暗带区(IP)%~,%~%,%~%,%~%,%~%;%~%,%~%,%~%,%~%,%~%。缺血半暗带和梗死区灌注参数值相关性:CBF与CBV最好,CBF与MTT及TTP与PE较好,而CBV与MTT稍差。结论 CTPI能够早期诊断急性缺血性脑卒中,通过定量分析,可区分梗死区及半暗带区。对于早期选择治疗方案,尤其是早期溶栓治疗具有重要意义,同时可预测患者预后。
关键词:卒中;CT;脑缺血;灌注成像;半暗带
Abstract:Objective To evaluate the application of16-detector spiral CT perfusi
on imaging(CTPI)in early acute isch-emic Routine CT scan and CTPI with GE Lightspeed16pro CT were performed in45patients with acute ischemic stroke(onset within24hours).Results In the present series of45patients,routine CT scan had sensitivity %and specificity %.CTPI had sensitivity %and specificity of100%.The results of2×2cross tabu-lation Chi-square test showed significant superioty in CTPI over routine CT scan(χ 2 =,P=<).The val-ues of95%confidence interval(CI)of rCBF(relative cerebral blood flow),rCBV(relative cerebral blood volume),rMTT(relative mean transmit time),rTTP(relative time to peak)and rPE(relative positive enhancement integral)in ischemic pen-umbra(IP)%~%,%~%,%~%,%~%%~%,respectively;while those in infarction %~%,%~%,%~%,%~%%~%, IP and infarction,the correlationship was best in CBF with CBV,good in CBFwith MTT,and relatively poor in TTP with PE and in CBVwith CTPI is useful for diagnosing early acute ischemic quantitative evaluation,it differentiates the core of infarction from IP,providing im-portant information for the choice