“一站式”多模态CT在急性缺血性脑卒中的应用

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Abstract Objective The perfusion imaging of"one-stop"multi-modality CT can reflect the abnormal perfusion of cerebral tissue in patients with cerebral infarction,while the CT cerebral angiography can clarify the vascular stenosis or occlusion in head and neck.In this paper,to discussed the value of"one-stop"multi-modal CT in the diagnosis of acute ischemic stroke.Methods A total of 96 patients with acute ischemic stroke within 4.5 to 24 h and admitted to the department of neurology in our hospital from June 2015 to December 2017 were selected as subjects.All participants were confirmed by magnetic resonance-diffusion-weighted imaging (MRI-DWI),but did not receive intravenous thrombolysis or embolectomy.The patients were examined by the"one-stop"multi-modal CT scan of the brain.The parameters of CT perfusion imaging(CTP)were observed and compared,and the relationship between the vascular stenosis and cerebral perfusion abnormality was analyzed by CT perfusion and vascular software.Results ①MRI was taken as the gold standard for acute ischemic stroke.The accuracy of NCCT scan was 39.6%,and the accuracy of multimodal CT was 93.8%.②For 90 patients with abnormal CTP perfusion,there were 38 cases with the ischemic penumbra.Both in the infarct core area and the ischemic penumbra,they had lower values of cerebral blood flow (CBF)in cerebral infarction side than in the contralateral mirrored area,the mean transit time (MTT)and time to peak (TTP)values were longer than the values in the contralateral mirrored area,the cerebral blood volume (CBV)in the infarct core area was significantly lower than that in the infarct mirror area,the differences were statistically significant(P＜0.05).However,for other 52 patients without the ischemic penumbra,values of all parameters except for CBV in cerebral infarction side were significantly different from the values in the contralateral mirrored area (P＜0.05).③CTA could effectively evaluate the degree and location of arterial stenosis,there was a relationship between the abnormal perfusion area and the degree of arterial stenosis(P＜0.05).Conclusion The “one stop” multi-modal CT examination of the brain is simple and rapid.It can demonstrate the hemodynamic changes and the morphology of the vessels in ACI patients,which is conducive to the early diagnosis of acute cerebral infarction,and is more conducive to individualized therapy.

Key words： CT perfusion CT angiography Acute ischemic stroke Penumbra

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	WANG Jin-ding
	WAN Shan-shan
	ZHANG Ji-lin
	YANG Chun-jing
	WAN He-bin

Cite this article:

WANG Jin-ding,WAN Shan-shan,ZHANG Ji-lin, et al. Application of acute ischemic stroke by “one-stop”multi-modality CT[J]. 中国当代医药, 2019, 26(17): 12-16.

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http://dangdaiyiyao.com/EN/ OR http://dangdaiyiyao.com/EN/Y2019/V26/I17/12

[1]	中华医学会神经病学分会.中华医学会神经病学分会脑血管病学组，中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志，2015，48（4）：246-257.
[2]	Allmendinger AM，Tang ER，Lui YW，et al.Imaging of stroke.Part 1.Perfusion CT-overview of imaging technique，interpretation pearls，and common pitfalls[J].AJR Am J Roentgenol，2012，198（1）：52-62.
[3]	黄文清，蔡辉，杨湘伟，等.CT灌注成像在诊断急性脑缺血中的运用和研究[J].中国 CT 和 MRI杂志，2015，13（11）：13-15.
[4]	Nogueira RG，Jadhav AP，Haussen DC，et al.Thrombectomy 6 to 24 hours after stroke with a mismatch between deficit and infarct[J].N Engl J Med，2018，378（1）：11-21.
[5]	Albers GW，Marks MP，Kemp ST，et al.Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging[J].N Engl J Med，2018，378（8）：708-718.
[6]	Kanekar SG，Zacharia TZ，Roller R.Imaging of stroke.Part 2.Pathophysiology at the molecular and cellular levels and corresponding imaging changes[J].AJR Am J Roentgenol，2012，198（1）：63-74.
[7]	梁立华，林景兴，陈志军，等.64层CT脑CTP联合头颈CTA对缺血性脑卒中早期诊断的临床应用研究[J].CT理论与应用研究，2016，25（4）：453-461.
[8]	Dorn F，Muenzel D，Meier R，et al.Brain perfusion CT for acute stroke using a 256-slice CT：improvement of diagnostic information by large volume coverage[J].Eur Radiol，2011，21（9）：1803-1810.
[9]	Bruce CV，Camp B，Sren C，et al.Cerebral blood flow is the optimal CT perfusion parameter for assessing infarct core[J].Stroke，2011，42（12）：3435-3440.
[10]	Klotz E，Konig M.Perfusion measurements of the brain：using dynamic CT for the quantitative assessment of cerebral ischemia in acute stroke[J].Eur J Radiol，1999，30（2）：170-184.
[11]	Shankar JJ，Langlands G，Doucette S，et al.CT perfusion in acute stroke predicts final infarct volume-inter-observer study[J].Can J Neurol Sci，2016，43（1）：93-97.
[12]	张元媛，柯开富.64排螺旋CT灌注成像在急性缺血性脑卒中的应用价值[J].中风与神经疾病杂志，2010，27（8）：720-722.
[13]	Campbell BC，Christensen S，Levi Cr，et al.Cerebral blood flow is the optimal CT perfusion parameter for assessing infart Core[J].Stroke，2011，42（12）：3435-3440.
[14]	虞雁南，丁信法，张圣，等.CT灌注预测急性缺血性卒中患者缺血半暗带和核心梗死区的最佳灌注参数阈值探讨[J].浙江大学学报（医学报）：2014，43（1）：7-13.
[15]	Alves JE，Carneiro A，Xavier J，et al.Reliability of CT perfusion in the evaluation of the ischaemic penumbra[J].Neuroradiol J，2014，27（1）：91-95.
[16]	邹梅，韩玺河，张晓莺，等.CT灌注成像对不明发病时间急性脑梗死患者溶栓治疗的疗效分析[J].中华老年心脑血管病杂志，2017，19（1）：47-50.
[18]	朱建国，杨亚芳，刘斐.64排螺旋CT脑灌注成像联合头颈部血管成像在急性脑梗死中的应用[J].医学研究生学报，2012，25（11）：1182-1185.
[19]	张亮，王赢，王振奎，等.急性脑梗死的320排动态容积CT脑灌注成像研究[J].中国实用神经疾病杂志，2017，20（17）：7-10.
[17]	Rosenthal ES，Schwamm LH，Roccatagliata L，et al.Role of recanalization in acute stroke outcome：rationale for a CT angiogram-based “benefit of recanalization”model[J].AJNR，2008，29（8）：1471-1475.