1 Department of Neurology, John Hunter Hospital, University of Newcastle, Newcastle, Australia.
2 Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.
Int J Stroke. 2018 Jul;13(5):469-472. doi: 10.1177/1747493018765493. Epub 2018 Mar 15.
Background Computed tomography perfusion is becoming widely accepted and used in acute stroke treatment. Computed tomography perfusion provides pathophysiological information needed in the acute decision making. Moreover, computed tomography perfusion shows excellent correlation with diffusion-weighted imaging and perfusion-weighted sequences to evaluate core and penumbra volumes. Multimodal computed tomography perfusion has practical advantages over magnetic resonance imaging, including availability, accessibility, and speed. Nevertheless, it bears some limitations, as the limited accuracy for small ischemic lesions or brainstem ischemia. Interpretation of the computed tomography perfusion maps can sometimes be difficult. The stroke neurologist faces complex or atypical cases of cerebral ischemia and stroke mimics, and needs to decide whether the "lesions" on computed tomography perfusion are real or artifact. Aims The purpose of this review is, based on clinical cases from a comprehensive stroke center, to describe the added value that computed tomography perfusion can provide to the stroke physician in the acute phase before a treatment decision is made.
背景 计算机断层扫描灌注技术在急性脑卒中治疗中得到广泛认可和应用。计算机断层扫描灌注提供了急性决策所需的病理生理学信息。此外，计算机断层扫描灌注与弥散加权成像和灌注加权序列具有极好的相关性，可用于评估核心梗死体积和缺血半暗带体积。与磁共振成像相比，多模态计算机断层扫描灌注具有实际优势，包括可用性、可及性和速度。然而，它也存在一些局限性，例如对小面积缺血性病变或脑干缺血的准确性有限。计算机断层扫描灌注图的解读有时可能较为困难。脑卒中神经科医生会遇到复杂或非典型的脑缺血和脑卒中模拟病例，需要判断计算机断层扫描灌注上的“病灶”是真实的还是伪影。目的 本综述旨在通过来自综合脑卒中中心的临床病例，描述在做出治疗决策之前的急性期，计算机断层扫描灌注可为脑卒中医生提供的附加价值。
