关键词: 急性脑梗死, CT灌注成像, 脑血管闭塞, 预后

Abstract: Objective To investigate the relationship between vessel abnormality and computed tomographic(CT) perfusion imaging(CTP) as well as the role of vessel abnormality in evaluating prognosis of patients with hyperacute cerebral infarction. Methods Nonenhancement CT, CTP and CTA were performed on 75 patients with acute internal carotid system cerebral infarction within 6 hours of symptom onset. Large vessel stenosis or occlusions on infarction side were assessed. National Institute of Health Stroke Scale score(NIHSS), Barthel Index(BI) and modified Rankin Scale(mRS) were used as evaluation index for neurological function impairment and extent of disability in prognosis. These scores were assessed on the same day, 14th and 90th days after stroke onset respectively. Results ① Of these 75 patients, 29 had normal vessel, 11 had middle cerebral artery stenosis, 13 patients with middle cerebral artery occlusion, 6 had internal carotid artery stenosis, and 16 had internal carotid occlusion. ② There were significant differences among groups of occlusion, stenosis and normal vessels in terms of cerebral blood flow(CBF) area, cerebral blood volume(CBV) area, time to peak(TTP) area, relative CBF(rCBF) and relative CBV(rCBV), CTP parameters of vessel occlusion were significantly different from those of normal vessels. Only CBF area of vessel stenosis group significantly increased compared with normal vessels. The areas of CTPabnormalities(area of CBF, CBV and TTP) of vessel occlusion were significantly greater than those of vessel stenosis(P<0.05). ③ Only the NIHSS was significantly different among three groups at the onset day, patients with normal cerebral arteries have better value than patients with vessel stenosis or occlusion. NIHSS, BI and mRS were all different among the three groups at 14th and 90th days after stroke onset respectively, patients with normal cerebral arteries had better values than patients with vessel occlusion(P<0.05). Conclusion The vessel abnormalities on infarction side in patients with acute cerebral infarction is associated with ischemic areas in indicated by CTP parameters and can be used as an evaluation index for clinical prognosis.

Key words: acute cerebral infarction, CT perfusion imaging, cerebral artery occlusion, prognosis