摘要
目的 探讨 C T脑灌注成像 ( C T perfusion,CTP)在短暂性脑缺血发作 (transient ischemic attack,TIA) 的应用价值。方法 收集我院从2013年 4月至2015年4月收治的55例短暂性TIA 患者作为研究对象,发病24h内进行CTP 和CTA(CT angiography)检查,发病72h 内进行头颅MRI(magnetic resonance imaging)和MRA(magnetic resonance angiography)进行检查,比较CTP与其他 检查方法的检出结果差异,并对病灶侧与 健康侧的脑灌注成像参数如获得达峰时 间(time to peak, TTP)、平均通过时间 (mean transit time, MTT)、脑血流量 (cerebral blood flow, CBF)、脑血容量 (cerebral blood volume, CBV)进行比较 分析。结果 CTA检出35个病灶,MRI检出 44个病灶,CTP检出59个病灶,CTP对病灶 的检出率高于CTA和MR检查,具有统计学 意义(P<0.05);CTP检出的病灶表现分 型中I1期12个,I2期29个,II1期11个, II2期7个,I2期明显多于其他分型,具有 统计学意义(P<0.05);CTP病灶侧的TTP 值、MTT值(P<0.05);CTP病灶侧的CBV值 与健康侧没有明显差异(P>0.05)。结论 采用CT脑灌注成像检查短暂性脑缺血发作 可以全面的诊断,对治疗短暂性脑缺血发 作提供可靠的依据。
Objective To study the application value of CT cerebral perfusion imaging(CTP) in Transient ischemic attack(TIA). Methods Fifty-five cases of transient ischemic attack from April 2013 to April 2015 in our hospital were collected as research subject, all of them were performed CTP, CTA(CT angiography) in 24 hours after onset and MRI(Magnetic Resonance imaging) and MRA(Magnetic Resonance angiography) in 72 hours. The inspection results of CTA and MRI and CTP were compared, and the parameters of CTP like time to peak(TTP), mean transit time(MTT), cerebral blood flow(CBF), cerebral blood volume(CBV) were analyzed and compared between lesion side and healthy side. Results Thirty-five lesions were checked out by CTA inspection, 44 lesions by MRI, and 59 lesions by CTP. The detection rate of CTP was higher than that of CTA and MRI, and it was significantly different (P<0.05). 12 lesions were checked out in I1 period by CTP, 29 in I2 period, 11 in II1 period and 7 in II2 period, the lesions of I2 were significantly more than the other period, and it is statistically different (P<0.05), the value of TTP, MTT, CBF and CTP between the lesion and Health side was significantly different (P<0.05), the CBV value of CTP between the lesion and Health side had no significant difference (P>0.05). Conclusions The CTP inspection can make a comprehensive diagnosis for transient ischemic attack and offer reliable basis for its treatment.
【关键词】短暂性脑缺血发作;CT脑灌注成像;CT血管成像
【中图分类号】R445.2;R445.3;R743.31
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2016.07.010
前言
短暂性脑缺血发作(Transient ischemic attack,TIA)是一种由 于局灶性缺血导致的短暂性脑、脊髓或视网膜神经功能失常,该病的 发生与脑血管痉挛、血液流动力学障碍以及微栓子脱落等有关系[1-2]。 TIA的症状持续时间比较短,大概数分钟,30min内就可以恢复到正常 状态,这种情况多发生于无急性脑梗死,当患者的症状持续超过2个小 时以后就会存在轻度神经功能缺损,采用CTA和MRI进行检查可以显示 出脑组织缺血征,但是对该疾病的检查采用CT和MR不能准确的判定全 部病灶的发病情况,而且发病比较轻的病灶与没有病灶的区别不能准 确区分。CTP可以全面的检查患者的病灶与没有病灶的情况,从而能更 准确的判定疾病的发生情况。本研究基于当前广泛应用的CT、MR检查 方法,对比CTA、MRI与CTP在短暂性脑缺血发作的诊断结果差异,探讨 CTP在短暂性脑缺血发作的应用价值。
中国CT和MRI杂志
第14卷, 第 7 期
2016年07月
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