CAJ | 학술논문

目的：探讨640层CT灌注联合血管成像在脑梗死超早期溶栓中的指导意义。方法对30例脑梗死超早期的患者，进行脑部CT平扫及640层CT灌注联合血管成像检查，根据脑血流量（ CBF ）、脑血容量、平均通过时间、达峰时间的变化及左右两侧CBF的比值，判定有无缺血半暗带；同时选择未做CT灌注检查的38例溶栓患者，对比它们之间的疗效。结果灌注指导的动静脉溶栓疗效优于非灌注指导的动静脉溶栓疗效。结论40层CT灌注联合血管成像在脑梗死超早期溶栓中具有指导意义，它能显示头颈部血管狭窄程度，确定有无缺血半暗带，可指导早期临床干预性溶栓或进行血管重建治疗，减少死亡率和致残率的发生。
목적：탐토640층CT관주연합혈관성상재뇌경사초조기용전중적지도의의。방법대30례뇌경사초조기적환자，진행뇌부CT평소급640층CT관주연합혈관성상검사，근거뇌혈류량（ CBF ）、뇌혈용량、평균통과시간、체봉시간적변화급좌우량측CBF적비치，판정유무결혈반암대；동시선택미주CT관주검사적38례용전환자，대비타문지간적료효。결과관주지도적동정맥용전료효우우비관주지도적동정맥용전료효。결론40층CT관주연합혈관성상재뇌경사초조기용전중구유지도의의，타능현시두경부혈관협착정도，학정유무결혈반암대，가지도조기림상간예성용전혹진행혈관중건치료，감소사망솔화치잔솔적발생。
Objective To investigate the guiding significance of 640 layer CT perfusion combined with vascular ima-ging in thrombolytic therapy for super acute cerebral infarction .Methods 30 cases of patients with superacute cere-bral infarction were taken the examination of brain CT scan and 640 CT layer perfusion combined with the vascular im-aging.The ischemic penumbra were determined according to the change of cerebral blood flow (CBF),regional cere-bral blood volume (rCBV),mean traverse time(MTT)and time to peak(TTP)in region of interest(ROI)and the ratio of left and right sides of CBF .At the same time ,38 patients were chosen to give thrombolytic therapy without CT perfu-sion imaging (20 patients with arterial thrombolytic therapy and 18 patients with intravenous thrombolytic therapy ) . Compare their discrepancy in efficacy .Results The effect of arteriovenous thrombolytic therapy guided by CT perfu-sion is better than that of non perfusion guidance of arteriovenous thrombolytic therapy .Conclusion It has a guid-ing significance in thrombolytic therapy for super acute cerebral infarction to make 640 CT perfusion combined with vascular imaging ,which can show that the degree of head and neck vascular stenosis and determine ischemic penumbra for guiding early clinical interventional thrombolytic therapy or vascular reconstruction treatment in order to save ische -mic penumbra and restore the blood perfusion of ischemic brain tissue as soon as possible .It has crucial clinical value to improve the prognosis and reduce the incidence of mortality and morbidity .