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脑梗塞前期患者的脑血流动力学的改变及多排CT灌注成像表现及分期

作者:叶长安

所属单位:辽宁省铁岭市中心医院影像科CT室(辽宁 铁岭 112000)

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摘要

目的探析多排CT灌注成像在脑 梗塞前期患者脑血流动力学改变及分期中 的应用。方法 选择2013年4月-2015年4月 来我院就诊的57例门诊/住院患者作为研 究对象,所有患者均行常规CT平扫、增强 扫描及动态CT扫描。获取rCBV、rCBF、 MTT、TTP等脑血流动力学参数脑并将病侧 与健侧各参数值进行比较以凸显脑梗塞前 期患者脑血流动力学变化情况。结果 患 者病侧与健侧的CBV值接近,比较无统计 学意义(P>0.05),但病侧CBF明显低于健 侧、MTT与TTP则高于健侧,提示脑梗死的 发生导致CBF减低、MTT与TTP延长,差异 的比较有统计学意义(P<0.05)。结论 多 排CT灌注成像可明确提示脑梗塞前期血流 动力学异常,并通过脑血流动力学参数变 化幅度对脑梗塞前期进行分期,掌握脑局 部低灌注的病理生理学状态,对于疾病防 治具有显著临床价值。

Objective To explore the application of CT perfusion imaging in changes and staging of cerebral hemodynamics in patients with pre-cerebral infarction. Methods 57 outpatients and inpatients admitted into the hospital for treatemtn during April 2013 to April 2015 were treated as the research objects. All patients underwent conventional CT plain scan, enhanced scan and dynamic CT scan. rCBV, rCBF, MTT, TTP and other cerebral hemodynamic parameters were obtained and the parameters of the diseased side and healthy side were compared to highlight the changes of cerebral hemodynamics in patients with pre-cerebral infarction. Results The CBV values of the diseased side and healthy side of patients were close and the comparison was not statistically significant (P>0.05), but CBF of the diseased side was significantly lower than that of the healthy side while MTT and TTP were higher than those of the healthy side. It suggested that the occurrence of cerebral infarction resulted in decreasing CBF and prolonged MTT and TTP. The differences were statistically significant (P<0.05). Conclusion Multi-slice CT perfusion imaging can clearly prompted hemodynamic abnormalities of pre-cerebral infarction. And through the change amplitude of cerebral hemodynamic parameters, precerebral infarction is staged to master the pathophysiological state of regional cerebral low perfusion, which is of significant clinical value in preventing and treating the disease.

【关键词】脑梗塞;前期;血流动力学; CT灌注成像;分期

【中图分类号】R743.3;R816

【文献标识码】A

【DOI】10.3969/j.issn.1672-5131.2015.12.014

前言

脑梗塞指脑组织局部动脉血流灌注减少或完全中断以致脑组织供 血与供氧受到影响[1],由于中老年人脑血管病发病率较高,因此实现 脑梗塞的早期诊断与治疗已经成为重点研究方向。影像技术的进步尤 其是多层螺旋CT为脑梗塞脑血流动力学的研究提供有效手段,我院应 用多排CT灌注成像于脑梗塞前期患者中,发现其利于发现脑血流动力 学的改变并进行分期,具有较高临床价值,报道如下。