摘要
目的探讨在急性脑梗死患者临床诊断及治疗过程中血管造影与双源CT脑灌注的应用价值。方法对2015年8月至2016年8月本院收治的64例急性脑梗死患者的一般资料进行回顾性分析,所有患者均经常规CT扫描排除出血性脑卒中,患者及家属均知情同意。对其实施常规CT平扫、双源CT脑灌注成像及血管造影检查,分析诊断结果,并对比患者梗死区及健侧镜像区脑血流量、脑血容量、对比剂达峰时间、平均通过时间等。结果本组64例急性脑梗死患者中,经由常规头颅CT平扫,结果显示,有49例发现病灶,均存在早期脑梗死征象,局部脑组织密度降低是主要临床症状,还伴有临近脑沟消失变形症状。双源CT脑灌注结果显示,本组64例患者均存在异常灌注区。其中,轻度降低9例,中度降低42例,重度降低13例。相较于健侧镜像区,病变区脑血容量、血流量明显减少,结果差异有统计学意义(P<0.05);相较于健侧镜像区,病变区对比剂达峰时间、平均通过时间明显增加,结果差异有统计学意义(P<0.05)。血管造影结果显示,本组64例患者中,一侧颈内动脉狭窄29例,左侧颈动脉闭塞6例,一侧大脑中动脉狭窄20例,左侧大脑中动脉闭塞9例。结论在急性脑梗死患者的临床诊断与治疗过程中,采用双源CT脑灌注成像进行检查,能对患者缺血部位、缺血程度等进行清晰显示。而实施血管造影检查,能准确显示病变血管范围。因此,在临床应用过程中,进行双源CT脑灌注与血管造影联合检测,能提升临床诊断效果,为急性脑梗死的对症治疗提供必要参考依据,值得进行深入研究和推广。
Objective To explore the clinical application value of angiography and Dual Source CT(DSCT)cerebral perfusion in the clinical diagnosis and treatment of acute cerebral infarction patients.Methods The retrospective study of 64 patients with acute cerebral infarction treated at Nanyang second general hospital from August 2015 to August 2016.All patients underwent conventional DSCT scan to exclude hemorrhagic stroke,and all the patients and their families had informed consent.Cerebral blood flow,cerebral blood volume,contrast peak time and mean transit time were calculated and compared contrast to contralateral mirror regions in patients who underwent conventional DSCT scan,DSCT perfusion imaging and angiography.Results The results of 64 cases with acute cerebral infarction by routine head DSCT scan were showed as follows:49 lesions had signs of early cerebral infarction,accompanied by the main clinical symptoms of cerebral density reduction and the adjacent sulci disappeared.The other 15 cases acute cerebral infarction had no abnormal signs by routine head DSCT scan.The results of DSCT cerebral perfusion showed that there were abnormal perfusion areas in all 60 cases:9 cases with mild reduction,42 cases with moderate reduction,and 13 cases with severe reduction.Lesions of cerebral blood volume and blood flow reducing significantly compared with the contralateral mirror regions(P<0.05).Lesion contrast peak time,the average time increasing significantly compared with the contralateral mirror regions(P<0.05).The results of 64 cases of Angiography were showed as follows:29 cases with unilateral internal carotid artery stenosis,6 cases with presence of left carotid artery occlusion,20 cases with one side middle cerebral artery stenosis,9 cases with left middle cerebral artery occlusion.Conclusion In the clinical diagnosis and treatment of patients with acute cerebral infarction,DSCT cerebral perfusion imaging is used to examine the ischemic position and the degree of ischemia.Angiography can accurately display the range of vascular lesions.Therefore,clinical application of combined detection of DSCT,cerebral perfusion and angiography,can enhance the effect of the clinical diagnosis and provide the necessary reference for the treatment of acute cerebral infarction.This method is easy to grasp and suitable for promotion in primary medical institutions.
作者
陈体
苏雪娟
李运奇
Chen Ti;Su Xuejuan;Li Yunqi(Department of Radiology,Nanyang Second General Hospital,Henan 437012,China)
出处
《实用医学影像杂志》
2019年第1期22-24,共3页
Journal of Practical Medical Imaging
关键词
脑梗塞
灌注成像
血管造影术
Brain infarction
Perfusion imaging
Angiography
