目的探讨CT灌注成像与测量CT 值差值在急性脑梗死中诊断中的应用价 值。方法 以我院放射科收治的36例急性 脑梗死患者为研究对象，根据其临床资 料进行回顾性分析和总结。分别对其进 行CT平扫和脑CT灌注成像检查，评价CT 灌注成像的达峰时间(TIP)、脑血流量 (CBF)、脑血容量(CBV)，测量两侧对称 部位CT值的差值。此外，另选36例无脑 部疾病，神经功能正常者为对照组，分 析CT灌注成像与测量CT值的差值在急性 脑梗死中的诊断价值。结果 36患者经 CT平扫，肉眼发现可疑病灶为17例，敏 感度47.2%，测量CT值差值发现可疑病 灶28例。经CT灌注成像检查发现3例CTP 正常，最终确诊为短暂性脑缺血发作， 其余异常，其rCBF、rCBV、rTTP明显改 变，病灶中心与病灶周边、对照侧相 比，p＜0.05，差异具有统计学意义。结 论 CT灌注成像与测量CT值的差值在急性 脑梗死的诊断中具有较高的应用价值， 能够在早期鉴别诊断脑梗死，通过定量 分析可以分辨梗死区和缺血半暗带区， 为临床判断梗死灶的存在及制定治疗方 案提供重要的依据。

Objective This Paper is to explore the application value of CT perfusion imaging and differential value of measured CT value in the diagnosis of acute cerebral infarction. Methods Thirty six patients with acute cerebral infarction admitted the Radiology Department of the Hospital were selected as research subjects, retrospective analysis and summary were conducted according to clinical data. CT plaint scan and brain CT perfusion imaging were made respectively, The time to peak (TIP), cerebral blood flow (CBF) and cerebral blood volume (CBV) of CT perfusion imaging were evaluated, the difference of CT value on both sides of symmetric positions was measured. In addition, 36 patients with no brain disease and normal nervous function were divided into the control group, and diagnostic value of the difference between CT perfusion imaging and CT measurement value in acute cerebral infarction was analyzed. Results It is visually found that there were 17 patients with suspicious lesions with the sensitivity at 47.2%, and it was found that there were 28 patients with suspicious lesions by measuring CT value difference. It was found that the CTP of 3 patients was normal CT perfusion imaging examination, and such 2 patients were finally diagnosed to suffer from transient ischemic attack, and others were abnomal, rCBF, rCBV and rTTP changed obviously, the comparison in lesion center and perimeter and controlled side satisfied p<0.05, and the differences were statistically significant. Conclusion CT perfusion imaging and the difference value in CT value measurement delivers high application value in the diagnosis of acute cerebral infarction, and it is capable of diagnosing cerebral infarction in early differential diagnosis, the infarct area and ischemic penumbra area may be differentiated via through quantitative analysis, providing important basis for clinical determination on the existence of infarct and development of therapeutic schedule.