目的 观察CT血管造影(CTA)联合 CT灌注成像(CTP)在急性脑梗死诊治中的 应用。方法 选择2016年1月至2017年6月 我院收治的急性脑梗死患者52例，均行CT 平扫、CTA与CTP检查，分析相关数据图 像。结果 52例患者CT平扫中33例未见明 显异常，19例发现缺血病灶。52例患者 CTP检查，显示均有与临床症状相符的脑 灌注异常区，且梗死区脑血容量(CBV)、 强化峰值 ( P E )分别为 ( 2 . 3 1± 0 . 5 6） mL/100g、(4.49±0.51)Hu，均明显低于 对侧相应区的(4.47±1.28)mL/100g、 (7.20±0.93）Hu(P<0.05)，峰值时 间(TTP)、平均通过时间(MTT)分别为 (13.02±1.18)s、(38.39±3.41)s，均 明显长于对侧相应区的(9.95±1.03)s、 (34.06±2.75)s(P<0.05)。52例患者发现 血管病变57处，其中大脑前动脉中度狭 窄4处，重度狭窄1处，闭塞1处；大脑中 动脉中度狭窄5处，重度狭窄5处，闭塞4 处；大脑后动脉中度狭窄3处，重度狭窄 2处，闭塞2处；基地动脉轻度狭窄4处， 中度狭窄5处，重度狭窄2处，闭塞1处； 颈内动脉颅内段轻度狭窄6处，中度狭窄 8处，闭塞4处。结论 CTA联合CTP检查简 便，可较好判断急性脑梗死梗死区域、血 流变化及血管狭窄情况，具有较高临床诊 疗价值。

Objective To observe the application of CT angiography (CTA) and CT perfusion (CTP) in diagnosis and treatment of acute cerebral infarction. Methods A total of 52 cases of patients with acute cerebral infarction treated in our hospital from January 2016 to June 2017 were selected and given CT plain scan, CTA and CTP. And the related data were analyzed. Results There were 33 cases without obvious abnormalities and 19 cases with ischemic lesions among 52 cases by CT plain scan. The results of CTP examination showed that there were cerebral perfusion abnormalities areas among 52 cases which were consistent with clinical symptoms, and the cerebral blood volume (CBV) and peak enhancement (PE) with (2.31±0.56) mL/100g and (4.49±0.51) Hu in the infarction area were significantly lower than those in the contralateral corresponding area with (4.47±1.28) mL/100g and (7.20±0.93) Hu (P<0.05), and the time to peak (TTP) and mean transit time (MTT) with (13.02±1.18) s and (38.39±3.41) s respectively were significantly longer than those in the contralateral corresponding area with (9.95±1.03) s and (34.06±2.75)s (P<0.05). A total of 57 vascular lesions were found in 52 cases, and there were 4 cases of moderate stenoses, 1 case of severe stenosis and 1 occlusion in anterior cerebral artery, and there were 5 cases of moderate stenosis, 5 severe stenosis and 4 occlusions in middle cerebral artery, and there were 3, 2 and 2 in posterior cerebral artery, and there were 4 mild stenosis, 5 moderate stenosis, 2 severe stenosis and 1 occlusion in base artery, and there were 6 mild stenosis, 8 moderate stenosis and 4 occlusions in intracranial segment of internal carotid artery. Conclusion CTA combined with CTP is easy to do, and it can determine the infarct area, the blood flow changes and the vascular stenosis of acute cerebral infarction better, and it has high clinical values for diagnosis and treatment.