Hunter G J, Hamberg L M, Ponzo J A, Huang-Hellinger F R, Morris P P, Rabinov J, Farkas J, Lev M H, Schaefer P W, Ogilvy C S, Schwamm L, Buonanno F S, Koroshetz W J, Wolf G L, González R G
Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, USA.
AJNR Am J Neuroradiol. 1998 Jan;19(1):29-37.
Our purpose was to determine the clinical feasibility of quantitative three-dimensional functional CT in patients with hyperacute stroke.
Twenty-two patients who underwent clinically indicated CT angiography were studied: nine patients had no stroke, eight had mature stroke, and five had hyperacute stroke (less than 3 hours since ictus). Maps were obtained of perfused cerebral blood volume (PBV), and CT angiograms were generated by using standard techniques.
Normal PBV values (mean +/- SEM) were 4.6 +/- 0.15% in the gray matter, 1.75 +/- 0.09% in the white matter, 2.91 +/- 0.20% in the cerebellum, 3.18 +/- 0.10% in the caudate, 2.84 +/- 0.23% in the putamen, 2.92 +/- 0.29% in the thalamus, and 1.66 +/- 0.03% in the brain stem. For patients with mature stroke, ischemic changes were visible on noncontrast, contrast-enhanced, and PBV scans. In patients with hyperacute stroke, ischemic changes were either absent or subtle before contrast administration, but became apparent on contrast-enhanced scans. Quantitative PBV maps confirmed reduced regional perfusion. CT angiograms in the hyperacute group showed occlusion of vessels in locations appropriate to the PBV deficits seen.
Quantitative three-dimensional functional CT is feasible for patients with hyperacute stroke. It is performed by using helical CT techniques, and yields measures of cerebrovascular physiological function, which are useful in this patient population.
我们的目的是确定定量三维功能CT在超急性卒中患者中的临床可行性。
对22例行临床指征CT血管造影的患者进行研究：9例无卒中，8例为陈旧性卒中，5例为超急性卒中（发病后不到3小时）。获取灌注脑血容量（PBV）图，并采用标准技术生成CT血管造影图像。
正常PBV值（均值±标准误）在灰质中为4.6±0.15%，白质中为1.75±0.09%，小脑中为2.91±0.20%，尾状核中为3.18±0.10%，壳核中为2.84±0.23%，丘脑中为2.92±0.29%，脑干中为1.66±0.03%。对于陈旧性卒中患者，在平扫、增强扫描和PBV扫描上可见缺血性改变。对于超急性卒中患者，在注射造影剂前缺血性改变不存在或不明显，但在增强扫描上变得明显。定量PBV图证实局部灌注减少。超急性组的CT血管造影显示在与所见PBV缺损部位相应的血管闭塞。
定量三维功能CT对超急性卒中患者是可行的。它通过螺旋CT技术进行，可得出脑血管生理功能的测量值，这对该患者群体很有用。
