CT脑灌注成像在脑梗死前期诊断中的应用(1)
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[摘要] 目的：探讨CT脑灌注成像在脑梗死前期诊断中的应用价值。方法：选取2009年11月~2010年12月收治的56例临床诊断为脑部局灶性缺血的患者，在发病24 h内于我院行CT、MRI和MRA检查，将CT、MRI、MRA检查结果进行比较。结果：56例患者在常规CT平扫和增强扫描中未发现任何新的脑梗死灶，CT脑灌注成像发现脑梗死前局部血流低灌注有52例，其中Ⅰ1期15例、Ⅰ2期26例、Ⅱ2期11例；MRI发现新发缺血灶34例；MRA发现单侧大脑中动脉狭窄15例，一侧大脑中动脉闭塞3例。结论：脑梗死前期脑组织局部血流灌注降低，常规CT平扫和增强、MRI对此敏感性较低。CT脑灌注成像可以在脑梗死发作超早期敏感发现脑组织局部血流的灌注变化，并且可以对低灌注血流的脑组织的病理生理学进行分期，对临床的诊断治疗有着极其重要的意义。
[关键词] 常规CT；MRI；MRA；灌注成像；脑梗死前期；局部低灌注
[中图分类号] R743 [文献标识码] B [文章编号] 1673-7210(2011)11(c)-107-03
Application of CT perfusion imaging in the cerebral regional hypoperfusion at the pre-infarction stage
REN Xiaofang
Department of CT Room, Chuzhou People's Hospital of Huai′an City, Jiangsu Province, Huai′an 223200, China
[Abstract] Objective: To explore the value of the CT cerebral perfusion imaging for the regional cerebral hypoperfusion at the pre-infarction stage. Methods: 56 patients with brain focal ischemia in our hospital from November 2009 to December 2010 were examined by CT, MRI, MRA in 24 hours after attack, and the results were compared. Results: There were not any new cerebral infarctions which were found in 56 patients with conventional CT scan and contrast scan, the cerebral infarction local blood low perfusion was found in 53 patients with CT perfusion imaging, and 15 cases of Ⅰ1 period, 26 cases of Ⅰ2 period, 11 cases of Ⅱ2 period; the new ischemia focal was found in 34 cases with MRI, 15 cases of unilateral middle cerebral artery stenosis and 3 case of middle cerebral artery blocking were found by MRA. Conclusion: The tissue perfusion of local cerebral infarction is low. Conventional CT scan, contrast scan, MRI have low sensitivity for it. CT perfusion imaging may depict cerebral hypoperfusion in pre-infarction period and make pathological physiology stage of brain tissue. So it is very important in diagnosis and treatment of pre-infarction stage of cerebral regional.
[Key words] Conventional CT; MRI; MRA; Cerebral regional hypopersion; Pre-infarction; Perfusion imaging
急性脑梗死发作前期脑组织的灌注压力下降导致脑部血流循环发生异常，继而脑循环的储备能力发生失代偿性低灌注导致神经元不可逆转的改变，发生脑梗死。脑梗死发生前存在一段潜伏期，脑梗死前期的影像学改变对脑梗死的预后有着极为重要的意义。我院2009年11月~2010年12月收治的56例临床诊断为脑部局灶性缺血的患者，在发病24 h内行CT、MRI和MRA检查 ......
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