灌注CT与稳定氙CT同步测量局部脑血流量：一项验证研究。
Simultaneous measurement of regional cerebral blood flow by perfusion CT and stable xenon CT: a validation study.
作者信息
Wintermark M, Thiran J P, Maeder P, Schnyder P, Meuli R
机构信息
Department of Diagnostic and Interventional Radiology, University Hospital, Swiss Federal Institute of Technology, CHUV-BH10, 1011 Lausanne, Switzerland.
出版信息
AJNR Am J Neuroradiol. 2001 May;22(5):905-14.
BACKGROUND AND PURPOSE
Knowledge of cerebral blood flow (CBF) alterations in cases of acute stroke could be valuable in the early management of these cases. Among imaging techniques affording evaluation of cerebral perfusion, perfusion CT studies involve sequential acquisition of cerebral CT sections obtained in an axial mode during the IV administration of iodinated contrast material. They are thus very easy to perform in emergency settings. Perfusion CT values of CBF have proved to be accurate in animals, and perfusion CT affords plausible values in humans. The purpose of this study was to validate perfusion CT studies of CBF by comparison with the results provided by stable xenon CT, which have been reported to be accurate, and to evaluate acquisition and processing modalities of CT data, notably the possible deconvolution methods and the selection of the reference artery.
METHODS
Twelve stable xenon CT and perfusion CT cerebral examinations were performed within an interval of a few minutes in patients with various cerebrovascular diseases. CBF maps were obtained from perfusion CT data by deconvolution using singular value decomposition and least mean square methods. The CBF were compared with the stable xenon CT results in multiple regions of interest through linear regression analysis and bilateral t tests for matched variables.
RESULTS
Linear regression analysis showed good correlation between perfusion CT and stable xenon CT CBF values (singular value decomposition method: R(2) = 0.79, slope = 0.87; least mean square method: R(2) = 0.67, slope = 0.83). Bilateral t tests for matched variables did not identify a significant difference between the two imaging methods (P >.1). Both deconvolution methods were equivalent (P >.1). The choice of the reference artery is a major concern and has a strong influence on the final perfusion CT CBF map.
CONCLUSION
Perfusion CT studies of CBF achieved with adequate acquisition parameters and processing lead to accurate and reliable results.
背景与目的
了解急性卒中病例中的脑血流量（CBF）改变对这些病例的早期管理可能具有重要价值。在能够评估脑灌注的成像技术中，灌注CT研究涉及在静脉注射碘化造影剂期间以轴向模式连续采集脑CT切片。因此，在紧急情况下很容易进行。CBF的灌注CT值已在动物实验中被证明是准确的，并且灌注CT在人体中也能提供合理的值。本研究的目的是通过与已报道准确的稳定氙CT结果进行比较，验证CBF的灌注CT研究，并评估CT数据的采集和处理方式，特别是可能的去卷积方法和参考动脉的选择。
方法
对患有各种脑血管疾病的患者在几分钟内进行了12次稳定氙CT和灌注CT脑部检查。通过使用奇异值分解和最小均方方法进行去卷积，从灌注CT数据中获得CBF图。通过线性回归分析和匹配变量的双侧t检验，将多个感兴趣区域的CBF与稳定氙CT结果进行比较。
结果
线性回归分析显示灌注CT和稳定氙CT的CBF值之间具有良好的相关性（奇异值分解方法：R(2)=0.79，斜率=0.87；最小均方方法：R(2)=0.67，斜率=0.83）。匹配变量的双侧t检验未发现两种成像方法之间存在显著差异（P>.1）。两种去卷积方法等效（P>.1）。参考动脉的选择是一个主要问题，对最终的灌注CT CBF图有很大影响。
结论
采用适当的采集参数和处理方法进行的CBF灌注CT研究可得出准确可靠的结果。
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