Terada T, Nishiguchi T, Hyotani G, Miyamoto K, Hayashi S, Komai N, Nakamura Y, Moriwaki H
Department of Neurological Surgery, Wakayama Medical College, Japan.
Neurol Med Chir (Tokyo). 1991 Oct;31(10):641-6. doi: 10.2176/nmc.31.641.
Dynamic computed tomography (DCT) was evaluated as a diagnostic indicator for chronic supratentorial ischemia in 50 cases with or without minor neurological deficits. Peak height (PH, the maximum value of the gamma fitted curve), peak time (PT, the time to PH from the start of DCT), transit time (TT, the time between the first and second inflection points of the gamma fitted curve), and their functional maps were analyzed. Cerebral angiography was then performed in all cases to identify stenotic or occlusive vascular lesions in major cerebral arteries. DCT clearly detected 12 of 13 occlusions of the internal carotid artery (ICA) or middle cerebral artery (MCA), although one ICA occlusion was masked by the contralateral MCA occlusion. However, DCT detected only severe ICA or MCA stenosis (more than 90%). Probably, stenotic lesions of less than 90% did not cause detectable hemodynamic compromise. DCT using PH, PT, and TT functional maps is a useful diagnostic method for hemodynamic changes in ischemic cerebrovascular disease, although bilateral lesions and less stenotic lesions (less than 90%) are difficult to detect.
对50例有或无轻度神经功能缺损的患者，评估动态计算机断层扫描（DCT）作为幕上慢性缺血的诊断指标。分析了峰值高度（PH，γ拟合曲线的最大值）、峰值时间（PT，从DCT开始到PH的时间）、通过时间（TT，γ拟合曲线的第一和第二拐点之间的时间）及其功能图。然后对所有病例进行脑血管造影，以确定大脑主要动脉中的狭窄或闭塞性血管病变。DCT清晰地检测到13例颈内动脉（ICA）或大脑中动脉（MCA）闭塞中的12例，尽管1例ICA闭塞被对侧MCA闭塞掩盖。然而，DCT仅检测到严重的ICA或MCA狭窄（超过90%）。可能，小于90%的狭窄病变未引起可检测到的血流动力学损害。使用PH、PT和TT功能图的DCT是一种用于缺血性脑血管病血流动力学变化的有用诊断方法，尽管双侧病变和狭窄程度较轻的病变（小于90%）难以检测。
