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目的探讨低剂量MSCT摇篮扫描技术一站式全脑灌注与动态CTA检查的可行性及其在评价脑动脉瘤中的优越性。方法选择63例临床疑诊脑动脉瘤的患者,分为两组,动态CTA组(33例)应用80 k V和100 m As的MSCT摇篮扫描技术进行一站式全脑灌注与动态CTA检查。常规CTA组(30例)CTA前平扫参数为100 k V和100 m As,CTA检查参数为100 k V和260 m As。对两组患者的辐射剂量与CTA图像质量分别进行比较;另对动态CTA组患者进行灌注分析。结果动态CTA组患者一站式脑灌注与动态CTA检查平均辐射剂量仅为(1.64±0.00)m Sv,常规CTA组患者平均辐射剂量为(1.68±0.17)m Sv,两组间差异无显著统计学意义(P>0.05)。动态CTA中最佳时相图像质量与常规CTA比较,血管强化程度及图像噪声较高,然而信噪比(SNR)、对比噪声比(CNR)差异无显著统计学意义(P>0.05)。94%(31/33)患者成功获得灌注图像,其中2例发现局限性灌注减低区域。结论低剂量MSCT摇篮扫描技术一站式脑灌注与CTA检查,能在不增加患者辐射剂量的前提下获得满意的图像质量,可实现脑动脉瘤患者动脉形态学与脑灌注功能的一站式综合评估。
Objective To investigate the feasibility of one-stop whole-brain perfusion and dynamic CTA with low-dose MSCT cradle scanning and its superiority in evaluating cerebral aneurysm. Methods Sixty-three patients with clinically suspected cerebral aneurysm were selected and divided into two groups. One-stop whole-brain perfusion and dynamic CTA were performed in the dynamic CTA group (n = 33) using MSCT cradle scanning techniques of 80 kV and 100 m As. The CTA pre-CTA scan parameters were 100 kV and 100 mAs in the conventional CTA group, and 100 kV and 260 mAs in the CTA. Radiation dose and CTA image quality of the two groups were compared respectively; in addition, the dynamic CTA group patients were perfusion analysis. Results In the CTA group, the mean radiation dose was only (1.64 ± 0.00) m Sv in one-stop cerebral perfusion and dynamic CTA, and (1.68 ± 0.17) m Sv in conventional CTA group. There was no significant difference between the two groups Significance (P> 0.05). Compared with conventional CTA, the enhancement of blood vessel enhancement and image noise were the best in dynamic CTA. However, there was no significant difference between SNR and CNR (P> 0.05). In 94% (31/33) patients, perfusion images were successfully obtained, and in 2 of them, localized perfusion was found to decrease the area. Conclusions One-stop cerebral perfusion and CTA examination with low-dose MSCT cradle scanning technique can achieve satisfactory image quality without increasing the radiation dose of the patient and can achieve a one-stop synthesis of arterial morphology and cerebral perfusion in patients with cerebral aneurysm Evaluation.