作　　者： (吴宝金）; (汤连志）; (刘志鹏）; (张浩）; (姜洪）;

机构地区： 黑龙江省医院CT室,哈尔滨150036

出　　处： 《中华解剖与临床杂志》 2017年第4期271-275,共5页

摘　　要： 目的 探讨多层螺旋CT灌注成像（CTP）评价早期静脉溶栓治疗急性脑梗死的临床应用价值.方法 回顾性分析2015年6月-2016年12月黑龙江省医院 CT室收集的80例急性脑梗死患者的CT影像资料.80例中,男46例、女34例,年龄20-75岁,均采用多层螺旋CTP指导静脉溶栓治疗.采用SPSS 16.0统计学软件进行分析处理,比较患者治疗前后病灶边缘区局部脑血流量（rCBF）、局部脑血容量（rCBV）和对比剂平均通过时间（MTT）.结果 80例中,常规头部CT平扫显示责任病灶35例,灵敏度43.75%（35/80）;多层螺旋CTP显示72例有责任病灶,灵敏度90.00%（72/80）;两种方法灵敏度、特异度比较,差异均有统计学意义（χ2=38.625、21.818, P值均〈0.01）.常规CT平扫在脑缺血24 h后才能显示出病灶区,采用常规CT平扫敏感性低.CTP的参数对比显示,治疗后rCBF（t=8.335, P〈0.01）和rCBV（t=3.016, P〈0.01）明显优于治疗前, MTT明显降低（t=5.226, P〈0.01）,差异具有统计学意义.结论 多层螺旋CTP技术能够观察急性脑梗死患者治疗前后脑血流动力学指标变化,为评价急性脑梗死患者溶栓治疗疗效提供依据. Objective To evaluate the value of multi-slice spiral CT perfusion（CTP） imaging in the treatment of acute cerebral infarction by early intravenous thrombolysis.Methods We retrospectively analyzed the data of 80 patients treated with multi-slice spiral CTP imaging in the treatment of acute cerebral infarction from June 2015 to December 2016 in the department of CT Room of Heilongjiang Provincial Hospital.In the 80 case of patients, 46 males and 34 females, 20-75 years old.SPSS 16.0 was used for statistical analysis, the renal cortical blood flow （rCBF）, local cerebral blood volume （rCBV）, and mean transit time （MTT） were compared before and after treatment.Results CTP imaging showed that 72 patients had a lesion with a sensitivity of 90.00% （72/80）.There was statistically significant between sensitivity and specificity（χ2=38.625, 21.818, all P values〈0.01）.And the sensitivity was 43.75% （35/80）.The data showed that conventional CT scan in the cerebral ischemia after 24 hours to show the lesion area, the use of conventional CT scan sensitivity was low.The rCBF and rCBV were significantly better than those before treatment（t=8.335, 3.016, all P values〈0.01）, and the MTT was significantly lower （t=5.226, P〈0.01）.Conclusions Multi-slice spiral CT perfusion imaging technique can be used to observe the changes of cerebral hemodynamics before and after treatment in patients with acute cerebral infarction, which will provide evidence for the evaluation of thrombolytic therapy in patients with acute cerebral infarction.

关 键 词： 体层摄影术 螺旋计算机 急性脑梗死 静脉溶栓 灌注