Koenig M, Klotz E, Luka B, Venderink D J, Spittler J F, Heuser L
Department of Radiology, Ruhr-University Bochum, Germany.
Radiology. 1998 Oct;209(1):85-93. doi: 10.1148/radiology.209.1.9769817.
To determine the value of perfusion computed tomography (CT) in a clinical study of patients with stroke and compare the results with single photon emission CT (SPECT) findings.
Perfusion CT was performed within 6 hours of symptom onset in 32 patients with possible stroke. Cerebral blood volume (CBV), cerebral blood flow (CBF), and time to peak contrast material enhancement were calculated on the basis of the CT results. Cerebral SPECT was also performed in a subgroup of 18 patients. Perfusion CT and SPECT findings were compared in a lesion-by-lesion analysis. Perfusion CT results were compared with follow-up CT and magnetic resonance imaging findings.
Areas of reduced CBF were detected with the aid of perfusion CT in 25 of 28 patients with a proved infarct (sensitivity, 89%). The results of the CBF maps corresponded well to SPECT findings in 13 (81%) of 16 patients, but ischemia was located outside the scanning level in the other three patients and was therefore missed. Perfusion CT revealed various changes in CBF, CBV, and time to peak enhancement in ischemic territories.
Perfusion CT not only allows early detection of cerebral ischemia but also yields valuable information about the extent of perfusion disturbances.
在一项针对中风患者的临床研究中确定灌注计算机断层扫描（CT）的价值，并将结果与单光子发射CT（SPECT）的检查结果进行比较。
对32例可能患有中风的患者在症状发作后6小时内进行灌注CT检查。根据CT结果计算脑血容量（CBV）、脑血流量（CBF）以及对比剂增强峰值时间。还对18例患者的亚组进行了脑SPECT检查。在逐个病灶分析中比较灌注CT和SPECT的检查结果。将灌注CT结果与随访CT及磁共振成像结果进行比较。
在28例经证实为梗死的患者中，借助灌注CT在25例患者中检测到CBF降低区域（敏感性为89%）。16例患者中有13例（81%）的CBF图结果与SPECT检查结果吻合良好，但另外3例患者的缺血区域位于扫描层面之外，因此未被检测到。灌注CT显示缺血区域的CBF、CBV以及增强峰值时间有各种变化。
灌注CT不仅能早期检测脑缺血，还能提供有关灌注紊乱程度的有价值信息。
