Application Of Whole-Brain CT Perfusion Imaging With320-Detector Row CT In Acute Ischemic Cerebrovascular Diseases

Objective: To explore the initial application of whole-brain CTperfusion （CTP）imaging with320-detector row CT in patients withischemic cerebrovascular diseases.Methods: Conventional plain CT and CT perfusion （CTP）wereperformed on40patients diagnosed as transient ischemic attack (TIA)within a week after admitted to the hospital. Twenty patients diagnosed asacute cerebral infarction underwent plain CT and CTP within24h after theonset of symptoms. The parameter maps of mean transit time（MTT）, timeto peak（TTP）, cerebral blood flow （CBF）, and cerebral blood volume（CBV）were analyzed. Meanwhile dynamic CT angiography （4D-CTA）images were obtained. Follow-up MRI were performed in the20patientsdiagnosed as acute cerebral infarction within24h after the examination ofCTP.Results: Forty patients diagnosed as TIA with conventional plain CTwere enrolled,and5cases were found lacunar cerebral infarction,and35cases revealed normal.Abnormal perfusion changes corresponding to clinical symptoms were found in58areas with36cases of the40patientswith by CTP. Prolonged TTP and MTT, reduced CBF and increased or notchanged CBV were shown in the abnormal perfusion areas. The differencesof the TTP、 CBF、 MTT of affected side compared with that ofcontralateral side were significance (P﹤0.05). No significant difference ofCBV was detected between affected side and contralateral side (P﹥0.05).4D-CTA showed the responsible vascular stenosis or occlusion in varyingdegrees.32cases of the40patients were found stenosis,2cases occlusion,6cases normal.In the20patients with acute cerebral infarction,8cases were foundearly infarction, and12cases revealed normal on conventional plain CT,while32ischemic lesions corresponding to clinical symptoms were found inwhole-brain CTP. The core of ischemic lesion as compared with peripheralzone were found to have changed significantly (P﹤0.05).Follow-up MRIconfirmed that26lesions were infarct foci.4D-CTA showed the responsiblevascular stenosis or occlusion in varying degrees. Vascular stenosis werefound in14cases of the20patients, occlusion in2cases, normal in4cases.Conclusion: By whole-brain CT perfusion imaging with320-detector row CT with administration of one contrast medium bolus,full evaluation of acute ischemic cerebrovascular diseases can be achieved.