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低剂量CT灌注成像在康复期缺血性卒中患者中的应用价值

作者:付 冬

所属单位:南京医科大学附属苏州医院放射科(江苏 苏州 215001)

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摘要

目的研究低剂量CT灌注成像在 康复期缺血性卒中患者中的应用价值。 方法 选择2010年3月至2015年3月在我院 进行治疗的,康复期缺血性卒中患者100 例,根据随机数表法将两组患者分为观察 组和对照组各50例,在对两组患者进行 常规平扫的基础上,对照组采用常规剂量 (120kV、200mVAs)CT灌注成像,观察组采 用低剂量(80kV、200mVAs)CT灌注成像。 分别测量两组患者的脑血流量(cerebral blood flow, CBF)、脑血容量(cerebral blood volume, CBV)、平均通过时间 (mean transit time, MMT)、峰值时间 (time to peak, TTP)。结果 两组患者相 比,病灶中心区rCBF明显低于缺血区,差 异有统计学意义(P<0.05),不同组别相 同部位的rCBF基本一致,差异无统计学意 义(P>0.05)两组患者相比,病灶中心区 rCBV明显低于缺血区,差异有统计学意义 (P<0.05),不同组别相同部位的rCBV基 本一致,差异无统计学意义(P>0.05)两组 患者相比,相同部位的rCBV基本一致,差 异无统计学意义(P>0.05),两组患者相 比,病灶中心区rCBV明显低于缺血区,差 异有统计学意义(P<0.05)。结论 低剂量 CT灌注成像,在有效降低辐射剂量的同 时,能够有效评价患者病灶处的血流情 况,对临床治疗以及预后恢复具有重要意 义。

Objective To study the application value of low dose CT perfusion imaging in patients with ischemic stroke of convalescence. Methods One hundred patients with recovery stage of ischemic stroke were selected as object of study from March 2013 to March 2015 in our hospital. According to the stochastic indicator method, the patients were divided into observation group and control group of 50 cases each. in the two groups of patients, on the basis of routine scan control group using conventional dose (120 kv, 200 mvas) CT perfusion imaging, observation group with low doses (80 kv, 200 mvas) CT perfusion imaging. The two groups were measured in patients with cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MMT), time to peak (TTP). Results Compared two groups of patients, significantly lower rCBF of ischemic lesions central area, the difference was statistically significant (P<0.05), different groups rCBF of the same basic consistent, there was no statistically significant difference (P>0.05), compared two groups of patients significantly lower rCBV ischemic lesions central area, the difference was statistically significant (P<0.05), of the same parts of different groups rCBV, there was no statistically significant difference (P>0.05), compared two groups of patients with the same parts of rCBV, there was no statistically significant difference (P>0.05), compared two groups of patients, a significantly lower rCBV ischemic lesions central area, the difference was statistically significant (P<0.05). Conclusion Low dose CT perfusion imaging, while effectively reduce the radiation dose, can effectively evaluate the blood flow in patients with lesions in, is of great significance for clinical treatment and prognosis of recovery.

【关键词】低剂量CT灌注成像;康复期; 缺血性卒中;应用价值

【中图分类号】R445.2;R743

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2016.07.001

前言

脑卒中又称为急性脑血管疾病,它包括脑梗死、脑出血和脑血栓 等[1]。它的死亡率极高,目前在我国城乡居民的致死率仅低于恶性肿 瘤[2]。脑卒中并发症多,包括高血糖、心律失常和脑水肿等,因此治 疗难度大,不易控制[3]。本次研究中,主要针对不同剂量CT灌注成像 在康复期缺血性卒中患者中的应用价值进行分析比较,具体报道如 下。