目的探讨CT平扫(NCCT)、CT灌 注成像(CTP)及CT血管成像(CTA)对缺血性 卒中脑侧支循环的诊断价值。方法 选取 47例缺血性卒中患者，均于入院3d内接受 多模式CT(包括NCCT、CTP、CTA等)检查， 记录脑血流量(CBF)、脑血容量(VBV)、 平均通过时间(MTT)、达峰时间(TTP)等 CTP参数，随访患者90d后改良Rankin量表 (mRS)评分，并进行相关统计学分析。结 果 47例患者，多模式CT检查显示，18例 无血管异常，29例存在血管狭窄或闭塞。 29例存在血管狭窄或闭塞中侧支循环良好 者13例(侧支循环良好组)，侧支循环不良 者16例(侧支循环不良组)。侧支循环良好 组病灶侧较健侧CBF明显降低(P<0.05)， MTT、TTP明显延长(P<0.05)，两侧CBV 比较差异无统计学意义(P>0.05)，随 访90d，患者预后良好。侧支循环不良 组病灶侧较健侧CBV、CBF均明显减少 (P<0.05)，MTT、TTP明显延长(P<0.05)， 随访90d后的mRS评分显示，预后均较差。 结论 NCCT、CTP、CTA联合检查对于缺血 性卒中脑侧支循环评估及预后判断具有重 要价值。

Objective To explore the value of non-contrast CT (NCCT), CT perfusion imaging (CTP) and CT angiography (CTA) in the diagnosis of cerebral collateral circulation of ischemic stroke. Methods A total of 47 patients with ischemic stroke were selected and examined with multi-mode CT (NCCT, CTP, CTA) within 3d after admission. The cerebral blood flow (CBF), cerebral blood volume (VBV), mean transit time (MTT), time to peak (TTP) and CTP were recorded. All patients were followed up for 90d, and the modified Rankin scale (mRS) scores were recorded. Related statistical analysis was performed. Results In the 47 patients, the multi-mode CT examination showed that there were 18 cases without vascular abnormalities and 29 cases with vascular stenosis or occlusion. In the 29 cases with vascular stenosis or occlusion, there were 13 cases with good collateral circulation (good collateral circulation group) and 16 cases with poor collateral circulation (poor collateral circulation group). The CBF of the affected side was significantly lower than that of the contralateral side in the good collateral circulation group (P<0.05), and MTT and TTP were significantly longer than those of the contralateral side (P<0.05), without significant difference in CBV between the two sides (P>0.05). 90d of follow-up showed that the prognosis of patients in good collateral circulation group was good. In the poor collateral circulation group, the CBV and CBF of the affected side were significantly lower than those of the contralateral side (P<0.05), and the MTT and TTP were significantly longer than those of the contralateral side (P<0.05). 90d of follow-up showed that the prognosis of patients in poor collateral circulation group was poor. Conclusion The combined examination of NCCT, CTP and CTA is of great value in evaluating cerebral collateral circulation and the prognosis of ischemic stroke.