目的 探讨宝石能谱CT脑灌注在诊断脑血管疾病病变患者中的应用。方法 选择我院用“金标准”数字减影血管成 像(DSA)检测，及脑血管疾病诊断标准的脑血管疾病患者110例，分别采用普通CT及宝石能谱CT脑灌注进行检测， 分析110例患者采用普通CT诊断和宝石能谱CT诊断的符合率，采用普通CT检出疑似脑血管狭窄情况(采用SAMUELS标 准计算颅内血管狭窄)与宝石能谱CT诊断脑血管狭窄情况对比，及采用普通CT诊断和宝石能谱CT检出动脉斑块情 况。结果 宝石能谱CT在脑出血、脑梗死的检出率差异无统计学意义(P＞0.05)，宝石能谱CT在动脉瘤的检出率为 100.00%，明显高于普通CT，差异有统计学意义(P＜0.05)，采用SAMUELS标准宝石能谱CT检出患有血管狭窄患者比 普通CT多，诊断不同程度血管狭窄情况精确度高于普通CT，差异具有统计学意义(P＜0.05)，宝石能谱CT检出斑块 总数79.09%，远高于普通CT的21.82%，差异具有统计学意义(P＜0.05)。结论 宝石能谱CT脑灌注对脑血管病变患者 诊断效果显著。

Objective To explore the application of gemstone spectral CT cerebral perfusion in the diagnosis of patients with cerebrovascular diseases. Methods A total of 110 patients with cerebrovascular diseases who were diagnosed with “gold standard” digital subtraction angiography (DSA) and diagnostic criteria of cerebrovascular disease were selected and examined by common CT and gemstone spectral CT cerebral perfusion. The coincidence rate of common CT diagnosis and gemstone spectral CT diagnosis was analyzed, and the suspected cerebrovascular stenosis (using the SAMUELS standard for the calculation of intracranial vascular stenosis) by common CT and cerebrovascular stenosis by gemstone spectral CT were compared, and the detection situations of arterial plaque were compared between common CT diagnosis and gemstone spectral CT. Results There were no significant differences in the detection rates of cerebral hemorrhage and cerebral infarction by gemstone spectral CT (P>0.05), and the detection rate of aneurysms with 100.00% by gemstone spectral CT was significantly higher than that by common CT (P<0.05), and the number of patients with vascular stenosis by SAMUELS standard in gemstone spectral CT was more than that in common CT, and the accuracy in the diagnosis of different degrees of vascular stenosis was higher than that of common CT (P<0.05), and the total number of detected plaques by gemstone spectral CT was much higher than that by common CT (79.09% vs 21.82%) (P<0.05). Conclusion Gemstone spectral CT cerebral perfusion has significant diagnostic effects on patients with cerebrovascular diseases.