急性缺血性腦卒中的三維血流成像（英文）課件

1、3D Blood Volume Imaging Acute Ischemic StrokeKuncheng Li M.D.,Ph.D.Medical Imaging CenterDepartment of Radiology Xuanwu Hospital Capital Medical UniversityBeijing 100053 China Non-enhanced CT (NECT) : could exclude hemorrhage and indicate early signs of ischemic strokePerfusion CT (PCT) : shows hemo

2、dynamic statusCT angiography (CTA) : shows vascular occlusion locationComprehensive Imaging in 15 MinutesPerfusion CT Images from PCT: MIPCBFCBVTTP BUT: limited coverageWhole brain perfusionis ideal!Calculating 3D-PBV ImagesCTAlow pass filteringNECTRegistrationuses information3D PBVSkullBonesCSFBone

3、sVesselsPre-Studiesof 3D-PBVMaterials and Methods Twenty-five patients (7 women, 18 men; mean age 59 years; range 42-77 years) suffered from acute ischemic stroke of the anterior circulation were studied within 6h after onset of symptomsNECT, CTA and CTP were performed within an average time of 2.8

4、hours (range 1-6 hours) after onset of symptomsIntravenous or intra-arterial thrombolytic therapy was performed in 11 of 25 patients Follow-up CT and MRI examinations were done at 2 to 7 days for the depiction of definite infarction NECT: spiral mode covering the base to vertex reconstruct with 5/1m

5、m slice thickness CTP: dynamic scan 3 adjacent slices (28.8 mm thickness) covering the basal ganglia 40 ml non-ionic contrast, 8 ml/sec CTA: spiral mode covering C5 to vertex 60 ml non-ionic contrast, 4 ml/secCT Scan ProtocolResultsCTP: lesion volume significantly correlated with the follow-up CT (R

6、=0.776/P0.001 for CBF; R=0.723/ P0.001 for CBV; R=0.629/P=0.001 for TTP)PBV: lesion volume significantly correlated with the follow-up CT (R=0.837, P0.001)Volume cm3R=0.776P0.001R=0.723P0.001R=0.629P=0.001R=0.837P0.001CBF-follow-up CTCBV-follow-up CTTTP-follow-up CTPBV-follow-up CTResultsThrombolysis GroupCTP: the lesion volume significantly correlated with the follow-up plain CT CBF R=0.811,P0.001 CBV R=0.829,P0.001 TTP R=0.807,P0.001PBV: the lesion volume significantly correlated with the follow-up plain CT R=0.851,P0.001Jie Lu M.D.,Ph.D.Miao Zhang M.D.Xiangying Du M.D.,Ph.D.Yan Gao M.D.Yu