Naito Yukari, Tanaka Shigeko, Inoue Yuichi, Ota Shinsuke, Sakaki Saburo, Kitagaki Hajime
Department of Radiology, Wakakusa Daiichi Hospital, 1-6 Wakakusa-cho, Higashi Osaka 579-8056, Japan.
Radiat Med. 2008 May;26(4):227-36. doi: 10.1007/s11604-007-0219-2. Epub 2008 May 29.
We investigated the correlation between abnormal perfusion areas by computed tomography perfusion (CTP) study of hyperacute stroke patients and the final infarction areas after intraarterial catheter thrombolysis.
CTP study using the box-modulation transfer function (box-MTF) method based on the deconvolution analysis method was performed in 22 hyperacute stroke patients. Ischemic lesions were immediately treated with catheter thrombolysis after CTP study. Among them, nine patients with middle cerebral artery (MCA) occlusion were investigated regarding correlations of the size of the prolonged mean transit time (MTT) area, the decreased cerebral blood volume (CBV) area, and the final infarction area.
Using the box-MTF method, the prolonged MTT area was almost identical to the final infarction area in the case of catheter thrombolysis failure. The decreased CBV areas resulted in infarction or hemorrhage, irrespective of the outcome of recanalization after catheter thrombolysis.
The prolonged MTT areas, detected by the box-MTF method of CTP in hyperacute stroke patients, included the area of true prolonged MTT and the tracer delay. The prolonged MTT area was almost identical to the final infarction area when recanalization failed. We believe that a tracer delay area also indicates infarction in cases of thrombolysis failure.
我们研究了超急性卒中患者的计算机断层扫描灌注（CTP）研究中异常灌注区域与动脉内导管溶栓后最终梗死区域之间的相关性。
对22例超急性卒中患者采用基于去卷积分析法的盒式调制传递函数（box-MTF）方法进行CTP研究。CTP研究后立即对缺血性病变进行导管溶栓治疗。其中，对9例大脑中动脉（MCA）闭塞患者的平均通过时间（MTT）延长区域大小、脑血容量（CBV）降低区域大小与最终梗死区域的相关性进行了研究。
采用box-MTF方法，在导管溶栓失败的情况下，MTT延长区域几乎与最终梗死区域相同。CBV降低区域无论导管溶栓后再通结果如何，均导致梗死或出血。
超急性卒中患者CTP的box-MTF方法检测到的MTT延长区域包括真正MTT延长区域和示踪剂延迟区域。再通失败时，MTT延长区域几乎与最终梗死区域相同。我们认为，在溶栓失败的情况下，示踪剂延迟区域也提示梗死。
