Exploration Of The Relationship Between The Dual Source CT Perfusion Imaging Change Of Ischemic Stroke Penumbra And Clinical Prognosis Of Ischemic Stroke

Object:The relationship between cerebral ischemic penumbra changes and clinical outcomes has been studied by CT perfusion imaging, which is used to explore the possible mechanisms for clinical therapy.Methods:There are 41 patients with clinical diagnosis of acute cerebral infarction who were taken a CTP examination by dual-source spiral CT were divided into group I and group II according to the time of onset. The main parameters of the two groups, ipsilateral and contralateral CTP(CBF, CBV, MTT and TTP) are analysed and the ratio of the contralateral symmetrical parts to derived relative parameter values(r TTP, r CBF, r CBV and r MTT) are calculated, and then the CTP parameter of the infarct core area and penumbra are analysed also. Two groups of patients with neurological deficits degree were evaluated by the US National Institutes of Health Stroke Scale(NIHSS). Result:1、General Results: there are 22 cases of high blood pressure, 16 cases of high blood cholesterol, 5 cases of diabetes, 3 cases of impaired glucose tolerance, 5 cases of atrial fibrillation, 26 cases of ultrasound carotid plaque.2、CT scan results: there are 20 patients with cerebral infarction in the basal ganglia, 3 cases with a large area of infarction, 4 cases beside the lateral ventricle, 14 cases with multiple cerebral infarction.3、CT perfusion imaging results: all the perfusion maps in 26 cases of group I showed a penumbra, the perfusion images of 10 cases of 15 cases in group II showed a penumbra, and there are 5 cases no penumbra.4、Quantitative analysis of CT perfusion parameters: after the comparison of the contralateral in group I,absolute CBF, CBV, MTT, TTP of the ipsilateral ischemic penumbra are statistically significant(P <0.05), after the comparison of thecontralateral absolute CBF, CBV of the Infarct core area are significant(P <0.05), the absolute value of MTT, TTP of Infarct core area are not statistically significant(P> 0.05), after the comparison of contralateral in Group II l, the absolute CBF, CBV, MTT, TTP of the ischemic penumbra are statistically significant(P <0.05), and after the comparison of the contralateral, the absolute CBF, CBV, MTT, TTP of the Infarction are significant(P <0.05). Compared their relative value CBF, CBV between infarct core and penumbra In the group I, it is significant difference and are statistically significant(P <0.05), but their relative value MTT, TTP are not statistically significant(P> 0.05),Similarly,compared their relative value CBF, MTT, TTP between infarct core and penumbra In the group II, it is significant difference and are statistically significant(P <0.05), but their relative value CBV are not statistically significant(P> 0.05).5、NIHSS scores in the group I are negatively correlated with r CBF(P <0.05); NIHSS scores in the group II are negatively correlated with r CBV(P <0.05). Conclusion:1、CTP can use to determine the diagnosis of ischemic stroke and ischemic penumbra.2 、 There is a possibility of ischemic penumbra not only during hyperacute ischemic stroke but also between during the acute phase(within 6-24 hours) and during the subacute phase(24-72 hours).3、There is a negative correlation between relative value VBF of Penumbra and prognosis of NIHSS scores.4、CTP is an important method can be used to evaluate the hemodynamic of acute phase subacute phase of cerebral infarction, and it is important to guide the treatment and the prognostic.