CAJ | 학술논문

目的：探讨320排 CT 全脑灌注成像(CTP)在早期急性脑梗死中的临床应用价值。方法回顾性分析25例早期急性脑梗死的320排 CT 脑灌注成像资料,对比分析 CTP 灌注参数(CBF、CBV、MTT、TTP)和其对应灌注伪彩图在脑梗死区、缺血半暗带区(IP)及对应健侧区的变化。结果25例患者全脑 CTP 均发现灌注异常区,7例核心梗死区表现为 CBF 与 CBV 均较健侧明显下降,MTT 较健侧缩短,TTP 均较健侧明显延长；18例 IP 病灶 CBF 较健侧稍降低,CBV 较健侧稍增加或维持正常,MTT 及 TTP 均较健侧延长。脑梗死区与健侧对应区域比较,CBF、CBV、MTT、TTP 值均有显著性差异(P <0.01)；急性脑梗死 IP 区与梗死核心区比较,CBF、CBV、MTT 及 TTP 值差异均有明显统计学意义(P <0.01)；IP 区与健侧对应区比较,CBF、MTT、TTP 值差异均具有统计学意义(P <0.05),CBV 值差异无统计学意义(P >0.05),但显示血流呈下降的趋势。CTP 各参数相对应的伪彩图,可直接、形象地显示脑梗死区域血流的异常变化,尤其 MTT 图与 TTP 图对显示异常更清晰、敏感。结论320排 CT 全脑灌注成像对急性脑梗死的早期发现和判断是否存在缺血半暗带具有重要的价值。
목적：탐토320배 CT 전뇌관주성상(CTP)재조기급성뇌경사중적림상응용개치。방법회고성분석25례조기급성뇌경사적320배 CT 뇌관주성상자료,대비분석 CTP 관주삼수(CBF、CBV、MTT、TTP)화기대응관주위채도재뇌경사구、결혈반암대구(IP)급대응건측구적변화。결과25례환자전뇌 CTP 균발현관주이상구,7례핵심경사구표현위 CBF 여 CBV 균교건측명현하강,MTT 교건측축단,TTP 균교건측명현연장；18례 IP 병조 CBF 교건측초강저,CBV 교건측초증가혹유지정상,MTT 급 TTP 균교건측연장。뇌경사구여건측대응구역비교,CBF、CBV、MTT、TTP 치균유현저성차이(P <0.01)；급성뇌경사 IP 구여경사핵심구비교,CBF、CBV、MTT 급 TTP 치차이균유명현통계학의의(P <0.01)；IP 구여건측대응구비교,CBF、MTT、TTP 치차이균구유통계학의의(P <0.05),CBV 치차이무통계학의의(P >0.05),단현시혈류정하강적추세。CTP 각삼수상대응적위채도,가직접、형상지현시뇌경사구역혈류적이상변화,우기 MTT 도여 TTP 도대현시이상경청석、민감。결론320배 CT 전뇌관주성상대급성뇌경사적조기발현화판단시부존재결혈반암대구유중요적개치。
Objective To explore the clinical value of whole-brain CT perfusion imaging with 320-detector row CT in early acute cerebral infarction.Methods The CTP parameters(CBF,CBV,MTT,TTP)and its pseudo color map of 25 patients with early acute cerebral infarction were retrospectively analysed and compared between infarction area,ischemic penumbra (IP)and the con-tralateral normal region.Results The abnormal perfusion area were found on CTP in 25 patients with early acute cerebral infarction. CTP showed cerebral blood flow (CBF)and cerebral blood volume (CBV)decreased significantly,mean transit time (MTT)short-ened significantly,time to peak (TTP)was significantly longer than those of the contralateral normal region in 7 cases of acute cere-bral infarct core.18 cases of IP lesions showed CBF decreased slightly,CBV increased slightly or maintain normal,MTT and TTP extension compared with contralateral.CBF,CBV,MTT,TTP values had significantly differences between infarct region and the contralateral corresponding normal region,between the infarct core area and IP of acute cerebral infarction (P <0.01).CBF,MTT, TTP values had statistically significant(P <0.05),and CBV values was not statistically significant (P >0.05)between IP region and the contralateral corresponding normal region,but showed a downward trend in blood flow.Parameter color maps of CTP could di-rectly,clearly and sensitively show abnormal changes region about cerebral blood flow.In particular,MTT and TTP maps shows ab-normal region clearer and sensitively.Follow-up 18 cases of IP,active lesions deduced in 6 cases,the lesions disappeared in 5 pa-tients (CT/ MRI showed no abnormal,and the clinical symptoms disappeared)after thrombolytic therapy,7 cases of MRI and CT scans confirmed infarction stove.Conclusion Whole-brain CTP with 320-detector row CT can early show the acute cerebral infarc-tion and its ischemic penumbra,it has significant important clinical value for early acute cerebral infarction.