Xu Fang-hong, Chen Wei-jian, Yang Yun-jun, Duan Yu-xia, Fu Feng-li
Department of Radiology, First Affiliated Hospital, Wenzhou Medical College, Wenzhou 325000, China.
Chin J Traumatol. 2008 Jun;11(3):186-9. doi: 10.1016/s1008-1275(08)60039-5.
To evaluate the application value of multislice computed tomographic perfusion imaging (MSCTPI) and multislice computed tomographic angiography (MSCTA) on traumatic cerebral infarction.
MSCTA was performed on 10 patients who were initially diagnosed as traumatic cerebral infarction by normal conventional computed tomography (NCCT), among whom, 3 patients were examined by MSCTPI simultaneously. Reconstructed images of the intracranial artery were made with techniques of maximum intensity projection (MIP) and volume rendering (VR) from MSCTA scanning data. Then the graph of function of four parameters, regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV), mean transit time (MTT), and time to peak (TTP), acquired by the perfusing analysis software was obtained.
Among the 10 patients with traumatic cerebral infarction, 6 showed complex type on NCCT, which depicted abnormality on MSCTA, and 4 showed simple type on NCCT, which had negative results on MSCTA. Among the 4 patients with abnormal great vessels, 2 suffered from stenosis or occlusion of the middle cerebral artery, 1 from spasm of the anterior cerebral artery, and 1 from spasm of the vertebral-basal artery. The image of MSCTPI of 1 patient with massive cerebral infarction on the right cerebral hemisphere confirmed by CT was smaller than those of the other patients, which showed occlusion of the ipsilateral middle cerebral artery on MSCTA. Among the 6 patients whose MSCTA showed no abnormality, 4 showed simple infarction and 2 showed complex infarction. The infarction focus of 5 patients occurred in the basal ganglia and 1 in the splenium of corpus callosum. Among the 2 cases of small cerebral infarction volume on NCCT, one was normal, the other showed hypoperfusion on MSCTPI and was normal on MSCTA.
The combination of MSCTPI and MSCTA is very useful for evaluating the change of intracranial artery in ischemic regions and assessing the cerebral hemodynamic information of traumatic cerebral infarction.
评估多层螺旋CT灌注成像（MSCTPI）及多层螺旋CT血管造影（MSCTA）在外伤性脑梗死中的应用价值。
对10例初诊为外伤性脑梗死的患者行MSCTA检查，其中3例同时行MSCTPI检查。利用MSCTA扫描数据通过最大密度投影（MIP）和容积再现（VR）技术重建颅内动脉图像。然后获得灌注分析软件得出的四个参数，即局部脑血流量（rCBF）、局部脑血容量（rCBV）、平均通过时间（MTT）和达峰时间（TTP）的功能图。
10例外伤性脑梗死患者中，6例在常规CT（NCCT）上表现为复杂型，MSCTA显示异常；4例在NCCT上表现为简单型，MSCTA结果为阴性。4例大血管异常患者中，2例为大脑中动脉狭窄或闭塞，1例为大脑前动脉痉挛，1例为椎-基底动脉痉挛。CT证实为右侧大脑半球大面积脑梗死的1例患者的MSCTPI图像较其他患者小，MSCTA显示同侧大脑中动脉闭塞。6例MSCTA无异常的患者中，4例为简单梗死，2例为复杂梗死。5例患者的梗死灶位于基底节区，1例位于胼胝体压部。NCCT上2例脑梗死体积较小的病例中，1例正常，另1例MSCTPI显示灌注减低，MSCTA正常。
MSCTPI与MSCTA联合应用对外伤性脑梗死缺血区颅内动脉变化及脑血流动力学信息评估具有重要价值。
