CT灌注成像在急性缺血性脑卒中的临床应用(3)
四、影像检查方法的比较
目前氙CT，PET，单光子发射计算机断层成像(single photon emission computed tomography, SPECT)以及MR灌注成像(MR perfusion)等方法可提供脑血流量等信息；MR弥散成像可观察水分子的弥散运动，这些检查技术都可用于早期诊断急性缺血性脑卒中。但PET与SPECT需使用核素，且同氙CT一样都需要特殊的成像设备，且图像采集时间长。MR弥散成像与MR灌注成像只能在具有平面回波成像(echo planar imaging, EPI)的MRI机器上使用，成像时间较CT灌注成像长，且维持MRI急诊扫描的成本也较CT灌注成像高。与之相比，尽管CT灌注成像需要注射对比剂，对碘剂过敏的病人不能使用此项技术；需要快速团注对比剂，并非全部病人都可耐受；只能做单层或几个层面的观察，所能提供的灌注信息有限；病人受到X线辐射。但CT 灌注成像具有经济实用，无需使用放射性同位素及氙气，图像的空间分辨率高，扫描设备简单，成像时间短，能够获得MTT、RF等多个脑血流动力学参数等优点。在我国目前绝大多数的中高档CT扫描机都可进行CT灌注成像，因此，这项技术便于广泛推广。随着CT扫描及成像技术尤其是多层CT扫描技术的发展，CT灌注成像在脑内缺血性疾病中的临床应用必将更加广泛。
, 百拇医药
参考文献
1. CT灌注成像在颅脑的临床应用研究. 中华放射学杂志, 1999;33:439-441
2. CT灌注成像在脑内缺血性疾病的初步应用. 中华放射学杂志, 1999;33:452-456
3. Latchaw RE. Neuroradiology Research: The opportunities and the challenges. Radiology 1998;209:3-7.
4. Kong M, Klotz E, Luka B, et al. Perfusion CT of the Brain: Diagnostic Approach for early Detection of Ischemic Stroke. Radiology 1998; 209:85-93.
, 百拇医药
5. Miles.KA. Measurement of Tissue Perfusion by Dynamic Computed Tomography. BJR,1991,64:409-412.
6. Hamberg LM, Hunter GJ, Halpern EF, et al. Quantitave, High Resolution Measurement of Cerebral Vascular Physiology with Slip-ring CT. AJNR,1996,17:639-650.
7. Hamberg LM, Hunter GJ, Kierstead D, et al. Measurement of Quantitave CBV with Subtraction Three-Dimentional Functional CT. AJNR,1996,17:1861-1869.
, 百拇医药
8. Hunter GJ, Hamberg LM, Ponzo JA, et al. Assessment of Cerebral Perfusion and Arterial Anatomy in Hyperacute Stroke with Three- Dimentional Functional CT: Early Clinical Results. AJNR,1998,19:29-37.
9. K.M, K.RV, J.O, et al. Potential of CT angiograpjy in Aute Ischemic Stroke. AJNR,1997,18:1001-1010.
10. Sh.DA, Tanaka.H, N.Y, et al. CT angiographyin the evaluation of acute stroke. AJNR,1997,18:1011-1020.
, http://www.100md.com
11. Osborn.AG, Tong.KA. Handbook of Neuroradiology:Brain and Skull. St Louis: Mosby ,1996,373-388.
12. Dillon.WP. CT Techniques for Detecting Acute Stroke and Collateral Circulation: In Search of the Holy Grail. AJNR, 1998,19:191-192.
13. Na DG, Byun HS, Lee KH, et al. Acute occlusion of the middle cerebral artery: early evaluation with triphasic helical CT-preliminary results. Radiology, 1998, 207:113-122.
, 百拇医药
14. Xiang Liu, JP Dai. Evaluation of CT perfusion imaging in the intravenous thrombolysis treatment of acute ischemic stroke within 12 hours. Radiology, 2000, 217(p): 387.
15. Xiang Liu, JP Dai. Comparison study of CT perfusion imaging and SPECT in the clinical application of moya-moya disease. Radiology,2000, 217(p):429-430.
16. Xiang Liu, JP Dai. CT perfusion imaging and CT subtraction angiography in acute stroke. Radiology, 1999,213(p):485., 百拇医药(刘翔 戴建平)
目前氙CT，PET，单光子发射计算机断层成像(single photon emission computed tomography, SPECT)以及MR灌注成像(MR perfusion)等方法可提供脑血流量等信息；MR弥散成像可观察水分子的弥散运动，这些检查技术都可用于早期诊断急性缺血性脑卒中。但PET与SPECT需使用核素，且同氙CT一样都需要特殊的成像设备，且图像采集时间长。MR弥散成像与MR灌注成像只能在具有平面回波成像(echo planar imaging, EPI)的MRI机器上使用，成像时间较CT灌注成像长，且维持MRI急诊扫描的成本也较CT灌注成像高。与之相比，尽管CT灌注成像需要注射对比剂，对碘剂过敏的病人不能使用此项技术；需要快速团注对比剂，并非全部病人都可耐受；只能做单层或几个层面的观察，所能提供的灌注信息有限；病人受到X线辐射。但CT 灌注成像具有经济实用，无需使用放射性同位素及氙气，图像的空间分辨率高，扫描设备简单，成像时间短，能够获得MTT、RF等多个脑血流动力学参数等优点。在我国目前绝大多数的中高档CT扫描机都可进行CT灌注成像，因此，这项技术便于广泛推广。随着CT扫描及成像技术尤其是多层CT扫描技术的发展，CT灌注成像在脑内缺血性疾病中的临床应用必将更加广泛。
, 百拇医药
参考文献
1. CT灌注成像在颅脑的临床应用研究. 中华放射学杂志, 1999;33:439-441
2. CT灌注成像在脑内缺血性疾病的初步应用. 中华放射学杂志, 1999;33:452-456
3. Latchaw RE. Neuroradiology Research: The opportunities and the challenges. Radiology 1998;209:3-7.
4. Kong M, Klotz E, Luka B, et al. Perfusion CT of the Brain: Diagnostic Approach for early Detection of Ischemic Stroke. Radiology 1998; 209:85-93.
, 百拇医药
5. Miles.KA. Measurement of Tissue Perfusion by Dynamic Computed Tomography. BJR,1991,64:409-412.
6. Hamberg LM, Hunter GJ, Halpern EF, et al. Quantitave, High Resolution Measurement of Cerebral Vascular Physiology with Slip-ring CT. AJNR,1996,17:639-650.
7. Hamberg LM, Hunter GJ, Kierstead D, et al. Measurement of Quantitave CBV with Subtraction Three-Dimentional Functional CT. AJNR,1996,17:1861-1869.
, 百拇医药
8. Hunter GJ, Hamberg LM, Ponzo JA, et al. Assessment of Cerebral Perfusion and Arterial Anatomy in Hyperacute Stroke with Three- Dimentional Functional CT: Early Clinical Results. AJNR,1998,19:29-37.
9. K.M, K.RV, J.O, et al. Potential of CT angiograpjy in Aute Ischemic Stroke. AJNR,1997,18:1001-1010.
10. Sh.DA, Tanaka.H, N.Y, et al. CT angiographyin the evaluation of acute stroke. AJNR,1997,18:1011-1020.
, http://www.100md.com
11. Osborn.AG, Tong.KA. Handbook of Neuroradiology:Brain and Skull. St Louis: Mosby ,1996,373-388.
12. Dillon.WP. CT Techniques for Detecting Acute Stroke and Collateral Circulation: In Search of the Holy Grail. AJNR, 1998,19:191-192.
13. Na DG, Byun HS, Lee KH, et al. Acute occlusion of the middle cerebral artery: early evaluation with triphasic helical CT-preliminary results. Radiology, 1998, 207:113-122.
, 百拇医药
14. Xiang Liu, JP Dai. Evaluation of CT perfusion imaging in the intravenous thrombolysis treatment of acute ischemic stroke within 12 hours. Radiology, 2000, 217(p): 387.
15. Xiang Liu, JP Dai. Comparison study of CT perfusion imaging and SPECT in the clinical application of moya-moya disease. Radiology,2000, 217(p):429-430.
16. Xiang Liu, JP Dai. CT perfusion imaging and CT subtraction angiography in acute stroke. Radiology, 1999,213(p):485., 百拇医药(刘翔 戴建平)