低剂量全脑CTP在急性脑梗死疗效评估中的价值

发布时间：2018-03-05 00:24

本文选题：脑梗塞　切入点：血栓溶解疗法　出处：《中国临床医学影像杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的:探讨128层螺旋CT行70 kV、100 mAs低剂量全脑CT灌注成像(CTP)在急性脑梗死疗效评估中的价值。资料与方法:选取23例发病24 h的急性脑梗死患者行头颅CT平扫及低剂量全脑CTP检查。7例行急诊静脉溶栓治疗,16例行常规药物对症支持治疗。治疗后7~10 d用相同扫描方案复查。对治疗前后病变中央区及边缘区相对脑血流量(rCBF)、相对脑血容量(rCBV)、相对达峰时间(rTTP)和相对平均通过时间(rMTT)进行分析比较。结果:急诊低剂量全脑CTP均发现与临床症状相对应的异常低灌注区。治疗后7~10 d复查,21例低灌注区范围较治疗前缩小,2例范围扩大。静脉溶栓患者治疗后病灶中央区rCBF与治疗前比较差异有统计学意义(P0.05),rCBV与治疗前比较差异无统计学意义(P0.05);常规药物治疗患者治疗后病灶中央区rCBF、rCBV与治疗前比较差异无统计学意义(P0.05)。静脉溶栓及常规药物治疗后病灶边缘区rCBF、rTTP、rMTT与治疗前比较差异有统计学意义(P0.05),rCBV差异无统计学意义(P0.05)。结论:低剂量全脑CTP在明显降低有效辐射剂量的同时,能早期诊断急性脑梗死,且能观察治疗前后脑血流动力学改变,结合头颅CT平扫及CTA,为临床评估急性脑梗死疗效提供全面影像学依据。
[Abstract]:Objective: to investigate the value of low dose global CT perfusion imaging (CTP) performed by 128-slice spiral CT in evaluating the efficacy of acute cerebral infarction. Materials and methods: 23 patients with acute cerebral infarction were selected to perform plain and low brain CT scans after 24 hours of acute cerebral infarction. Intravenous thrombolytic therapy was performed in 16 patients with emergency intravenous thrombolytic therapy. The same scanning regimen was used at 710 days after treatment. The relative cerebral blood flow in the central and marginal areas before and after treatment was compared. Brain blood volume (rCBV), relative peak time (rTTP) and relative mean transit time (RMTT) were compared and analyzed. Results: the abnormal low perfusion areas corresponding to clinical symptoms were found in emergency low-dose whole brain CTP. 21 cases of hypoperfusion were reexamined at the 7th day and 10th day after treatment. The area of injection was smaller than that before treatment in 2 patients with thrombolytic therapy. There was a significant difference in rCBF in the central area of the focus after intravenous thrombolytic therapy. There was no significant difference between the two groups before and after treatment, and there was no significant difference between the patients treated with conventional drugs and those before treatment. There was no significant difference in rCBFU rCBV between before and after treatment. There was no significant difference in rCBFU rTTPV after intravenous thrombolytic therapy and conventional drug therapy. Conclusion: there is no significant difference in rCBFU rCBV between before and after treatment. Conclusion: there is no significant difference in rCBFU rCBV between before and after treatment. Conclusion: there is no significant difference in rCBFU rCBV between before and after treatment. The dose of whole brain CTP significantly decreased the effective radiation dose at the same time, Early diagnosis of acute cerebral infarction and observation of cerebral hemodynamic changes before and after treatment combined with CT plain scan and CTAprovide a comprehensive imaging basis for clinical evaluation of the curative effect of acute cerebral infarction.
【作者单位】：上海市闵行区中心医院;上海交通大学医学院附属瑞金医院放射科;
【基金】：上海市闵行区卫生和计划生育委员会科研课题(编号2015MW10)
【分类号】：R743.33;R816.1

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