CT perfusion imaging and stages of regional cerebral hypoperfusion in pre-infarction period
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIOLOGY
- Issue:
- 10
- DOI:
- 10.3760/j.issn:1005-1201.2003.10.005
- Key Word:
- 灌注,局部;脑血管循环;体层摄影术,X线计算机;脑缺血;脑梗死;评价研究
Abstract： 目的探讨脑梗死前期动态CT灌注成像分期的应用价值.方法对32例临床诊断为脑局部缺血患者作了CT灌注成像和局部脑血流量(regional cerebral blood flow, rCBF)、局部脑血容量(regional cerebral blood volume, rCBV)、平均通过时间(mean transit time, MTT)和最大峰值时间(time-to-peak, TTP)比值(病侧 / 健侧)测量.根据影像学表现进行脑梗死前期的分期,包括Ⅰ1期: TTP延长,MTT、rCBF和rCBV正常;Ⅰ2期:TTP和MTT延长,rCBF正常,rCBV正常或轻度升高;Ⅱ1期:TTP、MTT延长以及rCBF下降,rCBV基本正常或轻度下降;Ⅱ2期:TTP、MTT延长,rCBF和rCBV下降.结果Ⅰ1期4例,CT灌注成像见脑局部TTP延长,MTT、rCBF和rCBV正常.rCBF、rCBV、MTT和TTP平均比值分别为1.00、1.00、1.00和1.30.Ⅰ2期13例,表现为脑局部TTP和MTT延长,rCBF和rCBV正常(8/13)或rCBV轻度增高(5/13).rCBF、rCBV、MTT和TTP平均比值分别为1.00、1.03、1.38和1.30.Ⅱ1期8例,CT灌注成像见TTP、MTT延长以及rCBF下降,rCBV正常(3/8)或轻度下降(5/8).rCBF、rCBV、MTT和TTP平均比值分别为0.56、0.94、1.49和1.47.Ⅱ2期4例,表现为脑局部区域TTP、MTT延长,rCBF和rCBV下降.rCBF、rCBV、MTT和TTP平均比值分别为0.42、0.59、1.57和1.55.3例CT灌注参数图未见异常区域.结论动态CT灌注成像可以清楚地显示脑梗死前期的血流动力学异常,并可根据各种参数的比值及相互关系提供相关的脑血流动力学的功能信息.脑梗死前期的影像学分期可以区分低灌注所致脑局部微循环的病理生理学状态,具有重要的临床应用价值.
- [1]陈星荣,沈天真.脑梗死的影像学[J].2000,(1).
- [2]高培毅,林燕.TIA患者脑动态CT峰值时间灌注成像的初步研究[J].2002,(1).
- [3]高培毅,林燕.微机辅助CT脑灌注成像以及定量测量[J].2002,(1).
- [4]Andersen G,Ostergaard L,Le-Bihan D,etc.Viability thresholds of ischemic penumbra of hyperacute stroke defined by perfusion-weighted MRI and apparent diffusion coefficient.[J].2001,32(5).
- [5]Ardekani BA,Okudera T,Miura Y,etc.Cerebral blood volume in acute brain infarction: A combined study with dynamic susceptibility contrast MRI and 99mTc-HMPAO-SPECT.[J].1999,30(4).
- [6]J R, Reichenbach,J, R?ther,L, Jonetz-Mentzel,etc.Acute stroke evaluated by time-to-peak mapping during initial and early follow-up perfusion CT studies.[J].1900,20.
- [7]Robert AR,Peeters A,Duprez TP,etc.Which MR-derived perfusion parameters are the best predictors of infarct growth in hyperacute stroke? Comparative study between relative and quantitative measurements.[J].2002,223(2).
- [8]Mataigne F,Oppenheim C,Peeters A,etc.Usefulness of magnetic resonance-derived quantitative measurements of cerebral blood flow and volume in prediction of infarct growth in hyperacute stroke.[J].2001,32(5).
- [9]Harold Adams,Birgitte Bendixen,L. Kappelle,etc.Classification of Subtype of Acute Ischemic StrokeDefinitions for Use in a Multicenter Clinical Trial[J].1993,24(1).
- [10]Koenig M,Klotz E,Kraus M,etc.Quantitative assessment of the ischemic brain by means of perfusion-related parameters derived from perfusion CT.[J].2001,32(2).