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目的:应用多层螺旋CT(MSCT)采用CT血管成像(CTA)与CT灌注成像(CTPI)相结合的技术探讨对脑动脉狭窄及缺血性脑血管病的诊断价值及超早期治疗的价值。方法:30例急性缺血性脑血管病(AICVD)患者行CT平扫,CTA和CTPI检查。对比观察梗死区和对侧对照区,梗死病灶中心区与周边区的血流动力学参数数值;分析AICVD与CTA变化的关系。结果:30例AICVD患者,CT平扫10例短暂性脑缺血发作(TIA)患者均未见异常,20例脑梗死(CI)患者有1例有小灶性低密度。CTA显示10例TIA患者中正常8例,狭窄2例;20例CI患者中19例均有不同程度的动脉狭窄,1例正常,为脑干梗死。CTPI显示未见异常者12例,其中10例TIA,2例CI(1例基底节区腔隙梗死,1例脑干梗死)。灌注异常者18例中,梗死侧与健侧、病灶中心与周边区rCBF、rCBV、TTP的差异有统计学意义。结论:CTA联合CTPI对早期AICVD有诊断价值,并能指导临床进行合理治疗。
Objective: To evaluate the diagnostic value of ultrasonography and ultra-early treatment of cerebral arterial stenosis and ischemic cerebrovascular disease by using multislice spiral CT (MSCT) combined with CT angiography (CTA) and CT perfusion imaging (CTPI). Methods: Thirty patients with acute ischemic cerebrovascular disease (AICVD) underwent CT scan, CTA and CTPI examination. The infarct size and contralateral control area, infarct center and peripheral hemodynamic parameters were compared. The relationship between AICVD and CTA changes was analyzed. Results: All 30 patients with AICVD showed no abnormalities in 10 cases of TIA, and 1 of 20 patients with cerebral infarction had focal low density. CTA showed that in 10 TIA patients, 8 were normal and 2 were stenosis. Among 20 patients with CI, 19 had varying degrees of arterial stenosis and 1 was normal, which was infarction of brainstem. CTPI showed no abnormalities in 12 cases, of which 10 cases of TIA, 2 cases CI (1 case of basal ganglia infarction, 1 case of brainstem infarction). In 18 cases of abnormal perfusion, the differences of rCBF, rCBV and TTP between infarct side and contralateral side, lesion center and peripheral area were statistically significant. Conclusion: CTA combined with CTPI has diagnostic value for early AICVD and can guide clinical reasonable treatment.