CAJ | 학술논문

目的探讨MRI检查显示无责任病灶的脑后循环缺血(PCI)患者的局部脑血流灌注情况,探索PCI患者早期诊断的有效方法.方法选取符合PCI临床诊断的24例患者行头颅MRI检查,对未发现责任病灶的患者进一步行CT灌注成像(CTPI)检查.在CTPI图像上手绘感兴趣区域(ROI),记录病灶区与对照区的灌注参数,包括局部脑血流量(rCBF)、局部脑血容量(rCBV)、平均通过时间(MTT)和达峰时间(TTP).结果 CTPI检查发现异常灌注18例(阳性率75%),缺血灶共26处,其中小脑10处(38.5%),枕叶7处(26.9%),颞叶3处(11.5%),脑干6处(23.1%).TTP发现异常15例,且均与临床症状相对应,rCBF发现异常13例,rCBV发现异常8例.脑梗死前期分期:玉1期4例,玉2期1例,域1期5例,域2期8例.病灶区的rCBF、rCBV、MTT及TTP与对照区相比较,差异均有统计学意义(P<0.01或0.05).结论 CTPI检查通过对PCI患者进行ROI半定量分析,可客观评价脑后循环脑血流灌注情况,发现头颅MRI检查所未能发现的缺血灶,为临床诊治PCI提供依据.
목적탐토MRI검사현시무책임병조적뇌후순배결혈(PCI)환자적국부뇌혈류관주정황,탐색PCI환자조기진단적유효방법.방법선취부합PCI림상진단적24례환자행두로MRI검사,대미발현책임병조적환자진일보행CT관주성상(CTPI)검사.재CTPI도상상수회감흥취구역(ROI),기록병조구여대조구적관주삼수,포괄국부뇌혈류량(rCBF)、국부뇌혈용량(rCBV)、평균통과시간(MTT)화체봉시간(TTP).결과 CTPI검사발현이상관주18례(양성솔75%),결혈조공26처,기중소뇌10처(38.5%),침협7처(26.9%),섭협3처(11.5%),뇌간6처(23.1%).TTP발현이상15례,차균여림상증상상대응,rCBF발현이상13례,rCBV발현이상8례.뇌경사전기분기:옥1기4례,옥2기1례,역1기5례,역2기8례.병조구적rCBF、rCBV、MTT급TTP여대조구상비교,차이균유통계학의의(P<0.01혹0.05).결론 CTPI검사통과대PCI환자진행ROI반정량분석,가객관평개뇌후순배뇌혈류관주정황,발현두로MRI검사소미능발현적결혈조,위림상진치PCI제공의거.
Objective To assess the diagnostic value of CT perfusion imaging in patients of posterior circulation ischemia (PCI) without responsible lesions on MRI scanning. Methods Twenty four patients with clinical diagnosis of PCI underwent MRI DWI examination, for the patients without responsible lesions on MRI, CTPI was then performed. The region of interest (ROI ) was hand-painted and the perfusion parameters of abnormal regions and normal regions were recorded, including regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV),mean transmit time (MTT) and time to peak (TTP). Results Out of 24 cases positive CTPI was detected in 18 with a positive rate of 75%. There were 26 ischemic focuses detected, including 10 in cerebel um (38.5%), 7 in occipital lobe (26.9%), 3 in temporal lobe (11.5%) and 6 in brainstem (23.1%). Abnormal regions were detected on the diagram of TTP in 15 cases and the findings were corresponded to clinical symptoms;those were detected by rCBF in 13 cases and those detected by rCBC in 8 cases. The stages of cerebral infarction prophase included I-1 in 4 cases, I-2 in 1 case, II-1 in 5 cased and II-2 in 8 cases. Conclusion CTPI can objectively evaluate cerebral blood flow perfusion and is of value in detection of ischemic focuses that are not found by MRI scanning.