Noguchi Kyo, Itoh Toshihide, Naruto Norihito, Takashima Shutaro, Tanaka Kortaro, Kuroda Satoshi
Departments of Radiology, Graduate School of Medicine and Pharmaceutical Science, University of Toyama, Toyama, Japan.
Department of Research & Collaboration, Siemens Healthcare, Tokyo, Japan.
J Stroke Cerebrovasc Dis. 2017 Jan;26(1):34-41. doi: 10.1016/j.jstrokecerebrovasdis.2016.08.025. Epub 2016 Sep 14.
We evaluated whether X-map, a novel imaging technique, can visualize ischemic lesions within 20 hours after the onset in patients with acute ischemic stroke, using noncontrast dual-energy computed tomography (DECT).
Six patients with acute ischemic stroke were included in this study. Noncontrast head DECT scans were acquired with 2 X-ray tubes operated at 80 kV and Sn150 kV between 32 minutes and 20 hours after the onset. Using these DECT scans, the X-map was reconstructed based on 3-material decomposition and compared with a simulated standard (120 kV) computed tomography (CT) and diffusion-weighted imaging (DWI).
The X-map showed more sensitivity to identify the lesions as an area of lower attenuation value than a simulated standard CT in all 6 patients. The lesions on the X-map correlated well with those on DWI. In 3 of 6 patients, the X-map detected a transient decrease in the attenuation value in the peri-infarct area within 1 day after the onset.
The X-map is a powerful tool to supplement a simulated standard CT and characterize acute ischemic lesions. However, the X-map cannot replace a simulated standard CT to diagnose acute cerebral infarction.
我们评估了一种新型成像技术X-map，能否在急性缺血性卒中患者发病后20小时内，使用非增强双能计算机断层扫描（DECT）可视化缺血性病变。
本研究纳入6例急性缺血性卒中患者。在发病后32分钟至20小时之间，使用2个分别运行在80 kV和Sn150 kV的X射线管进行头部非增强DECT扫描。利用这些DECT扫描，基于三物质分解重建X-map，并与模拟标准（120 kV）计算机断层扫描（CT）和扩散加权成像（DWI）进行比较。
在所有6例患者中，与模拟标准CT相比，X-map在将病变识别为低衰减值区域方面表现出更高的敏感性。X-map上的病变与DWI上的病变相关性良好。在6例患者中的3例中，X-map在发病后1天内检测到梗死灶周围区域的衰减值短暂下降。
X-map是补充模拟标准CT并表征急性缺血性病变的有力工具。然而，X-map不能替代模拟标准CT来诊断急性脑梗死。
