CAJ | 학술논문

目的：探讨多层螺旋 CT 全脑血管灌注成像在超急性脑梗死缺血半暗带诊断中的临床应用价值。方法选取65例超急性脑梗死疑诊患者，在患者发病后6 h 内行缺血部位的多层螺旋 CT 平扫、灌注成像及 CT 血管造影成像，分析灌注图像与 CT 血管造影的重建后处理图像。结果17例患者经普通 CT 扫描发现可疑脑缺血区，48例患者未发现明显异常；脑灌注图显示脑组织缺血部位与患者的临床症状相对应；多层螺旋 CT 血管造影显示大脑中动脉闭塞15例，大脑中动脉狭窄8例，基底动脉狭窄3例，颈内动脉狭窄4例。病变区 CBV、CBF 显著低于对照区，MTT 显著短于对照区，差异均有统计学意义（P <0.05）。结论多层螺旋 CT 灌注成像对临床诊断超急性脑梗死具有良好的特异性和敏感性，可以早期发现病变并进行量化分析，多层螺旋 CT 血管造影检查可以较及时地发现缺血性病变的原因，为进一步临床治疗方案的制定提供有力的理论依据。
목적：탐토다층라선 CT 전뇌혈관관주성상재초급성뇌경사결혈반암대진단중적림상응용개치。방법선취65례초급성뇌경사의진환자，재환자발병후6 h 내행결혈부위적다층라선 CT 평소、관주성상급 CT 혈관조영성상，분석관주도상여 CT 혈관조영적중건후처리도상。결과17례환자경보통 CT 소묘발현가의뇌결혈구，48례환자미발현명현이상；뇌관주도현시뇌조직결혈부위여환자적림상증상상대응；다층라선 CT 혈관조영현시대뇌중동맥폐새15례，대뇌중동맥협착8례，기저동맥협착3례，경내동맥협착4례。병변구 CBV、CBF 현저저우대조구，MTT 현저단우대조구，차이균유통계학의의（P <0.05）。결론다층라선 CT 관주성상대림상진단초급성뇌경사구유량호적특이성화민감성，가이조기발현병변병진행양화분석，다층라선 CT 혈관조영검사가이교급시지발현결혈성병변적원인，위진일보림상치료방안적제정제공유력적이론의거。
Objective To investigate the clinical application value of multi-slice CT perfusion im-aging on the diagnosis of cerebral vascular hyperacute cerebral ischemic penumbra. Methods Sixty-five suspected patients with hyperacute cerebral infarction were chosen,within 6 h after the onset,ischemic ar-ea was given unenhanced spiral CT perfusion imaging and CT angiography imaging. The reconstruction of the perfusion images and CT angiography post-processing images were analyzed. Results Suspicious cere-bral ischemia was found in 17 cases by normal CT scans,and there were no obvious abnormalities in 48 ca-ses by normol CT scans;cerebral perfusion showed that the ischemic site was in accordance with the clini-cal symptoms;multislice spiral CT angiography showed 15 cases of occlusion in the middle cerebral artery, 8 cases of middle cerebral artery stenosis,3 cases of basilar artery stenosis,4 cases of carotid artery steno-sis. At the area of lesion,CBV,CBF was significantly lower than that at the control area,MTT was signifi-cantly shorter than that at the control area,the differences were significant( P < 0. 05 ). Conclusions CT perfusion imaging in the clini-cal diagnosis of hyperacute cerebral infarction has good specificity and sensitivity,it can be used for early de-tection of disease and quantitative analysis,multi-slice CT angiography can be used for more timely discovery of the causes of ischemic lesions,and can provide strong theoretical basis for further clinical treatment plan.