Combined Application Of CT Perfusion Imaging With CT Angiography In The Diagnosis Of Acute Ischemic Stroke

Background: The cerebrovascular disease with its high morbidity, high disability rateand fatality rate threaten the human health, especially for the ischemic cerebrovasculardisease. For each individual, the most important thing was to seek the risk factors of theischaemic stroke and the preventative treatment, which was the medical professionconcern and research hotspot and difficulty. At present, there’re not many researchreports about comprehensive evaluation for ischemic stroke with head and neck arterialsystems narrow and occlusion through CTPI joint CTA in the world wide. Therefore,The focus of research is to evaluate the ischemic stroke through NNCT+CTPI+CTA this"one-stop" examination mode respectively from two aspects of morphology andhemodynamic.Objective: To explore joint16row helical CT perfusion imaging and angiographyimaging of acute ischaemic stroke diagnosis, ischemia, ischemic penumbra ofhemodynamic parameters change rule and judgment ischemia parts of the application,and to sum up the image characteristic to carry out rational treatment for clinicalprovide theoretical basis. The purpose is to reflect the value of this mode through CTPIjoint CTA to acute ischemic stroke diagnostic.Methods:40patients with clinical suspected acute cerebral ischemic stroke were doneNNCT+CTPI+CTA inspection by using Siemens16row helical CT, according to thecase, the criteria for the brain artery perfusion and head and neck by Siemenspost-processing software situation assessment. Firstly, after analyzing CTPI providedhemodynamic parameters understand tissue perfusion status, then, by CTA clear narrowregion and the degree, getting the collateral circulation compensatory characteristics.All cases were followed-up with plane CT after one week. Observing CT perfusion,recording CTP perfusion parameter values (CBF, CBV, MTT and TTP), evaluating CTAhaving the artery stenosis or not and the occlusion of lesion site. Finally, comprehensivethe hemodynamic characteristics and vascular morphological changes, collateral circulation status, and clinical analysis, analysing the relationship of intracranialvascular and neck with brain tissue perfusion narrow degree anomaly zones correlation.Results:40patients found on CT perfusion graph with clinical symptoms ofcorresponding perfusion abnormality area in35cases. The positive for87.5%, whichwas higher than the plane CT scans for25%. There were41places with clinicalsymptoms of corresponding perfusion abnormality on CT perfusion graph in35cases.The abnormal perfusion CBF（t=2.45）,CBV（t=3.07）, MTT（t=2.89）determined bythree groups compared with the contralateral parameters had a significant difference（P<0.05）. But the TTP parameters didn’t have an obvious statistical significance. CTAvascular examination results found internal carotid artery stenosis in12places;Intracranial artery stenosis in11places; Both of the internal carotid artery andintracranial arteries in10cases; There were no obvious abnormity head and neckvessels in18cases. Comparing these cases group CTPI joint CTA inspection result, theCTP existence of patients CTPI check responsibility vascular rate (95.65%) were higherthan those without responsibility vascular (76.47%).Conclusions:16slices CT perfusion has satisfying sensitivity and specificity indiagnosis of acute cerebral ischemic infarction, can find the ischemic penumbra andpredict clinical prognosis16slices. CTA can find cause of cerebral ischemic infarctionand provide precise evidence for further treatment.