| 张为,李小虎,吴宗山,等.多时相CT血管成像“一站”扫描对急性缺血性脑卒中的价值研究[J].安徽医药,2020,24(9):1835-1838. |
| 多时相CT血管成像“一站”扫描对急性缺血性脑卒中的价值研究 |
| The value of the multi-mode CT angiography "one-stop" scanning in acute ischemic stroke |
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| DOI：10.3969/j.issn.1009-6469.2020.09.036 |
| 中文关键词: 脑梗死 /诊断 卒中 脑缺血 体层摄影术，螺旋计算机 血管造影术，数字减影 弥散张量成像 CT灌注成像 侧支循环 |
| 英文关键词: Brain infarction/diagnosis Stroke Brain ischemia Tomography,spiral computed Angiography,digital subtrac- tion Diffusion tensor imaging CT perfusion imaging Cerebral perfusion |
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| 目的研究 Revolution CT多模式“一站”扫描对急性缺血性脑卒中的应用价值。方法选取安徽医科大学附属六安医院 2018年 12月至 2019年 5月 32例临床拟诊急性缺血性脑卒中病人，在急性期内进行 CT平扫( NCCT)、磁共振成像( MRI)、 CT血管成像( CTA)和 CT灌注成像( CTP)检查，根据小剂量测试所得峰值时间，制定 CTA+CTP检查的个体化扫描方案。应用 CT Brain Stroke软件进行全脑灌注分析，应用数字减影后 CTA数据行头颈部血管分析及三维成像、最大密度投影( MIP)等后处理经，再 CTP各时相 Refomat-MIP成像及 4D Neuro DSA软件对侧支循环进行动态观察，采用基于 CTA的软脑膜侧支评分( Pial Collateral Score)评价侧支循环，对侧支循环建立良好及不良组的病灶侧与对侧灌注参数进行对比分析。结果 32例病人中 30例有灌注异常，且有血管狭窄 29例；随着血管梗阻程度的加重，有梗死区( P＝0.037)、磁共振弥散加权成像( DWI)高信号 |
| 英文摘要: |
| Objective To study the value of the multi-mode one-stop scanning of the Revolution CT in acute ischemic stroke. Methods Thirty-two patients with clinically diagnosed acute ischemic stroke in Lu’an Hospital Affiliated of Anhui Medical Uni- versity from December 2018 to May 2019 were enrolled，and NCCP，MRI，CTA，and CTP were performed in the acute phase.An in-dividualized scanning protocol for CTA+CTP examination was developed based on the peak time obtained from the small dose test.Whole brain perfusion analysis was performed using CT Brain Stroke of GE AW 4.7 workstation.The digital silhouette method wasused for Virtual Reality(VR)reconstruction，maximum density projection(MIP)and vascular analysis of head and neck vessels.The collateral circulation was dynamically observed by CTP phase-time Remaxat-MIP imaging and 4D Neuro DSA software.The col-lateral circulation was evaluated by CTA-based Pial Collateral Score，and the lesion side and contralateral perfusion parameters of the well collateral circulation and the poor group were compared.Results Of the 32 patients，30 had abnormal perfusion，including29 patients with vascular stenosis.With the aggravation of vascular obstruction，the proportion of patients with infarcted area(P＝0.037)diffusion weighetd imging(DWI)high signal(P＝0.034)，and good collateral circulation(P＝0.011)gradually increased， stically significant difference.By contrast analysis of the retrograde filling time of the collateral circulation，the optimal phase of the collateral circulation observation was the second to third phases after the arterial phase(CTA)，and the best observa- tion time was 5 to 10 s after the arterial phase.When comparing the perfusion parameters between the lesion side and the well col-lateral circulation，there was no statistically significant difference in CBV，and the remaining differences were statistically signifi- withstati， |
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