CTP指导下脑梗死取栓治疗的研究进展

doi:10.3969/j.issn.1673-5765.2018.06.019

中国卒中杂志 ›› 2018, Vol. 13 ›› Issue (06): 626-630.DOI: 10.3969/j.issn.1673-5765.2018.06.019

CTP指导下脑梗死取栓治疗的研究进展

王天罡，宋彦丽，朱弘璐，李朝，林杰，武一平

1 056002 邯郸邯郸市第一医院神经内一科
2 河北工程大学医学院

收稿日期:2018-01-18 出版日期:2018-06-20 发布日期:2018-06-20
通讯作者: 武一平 15690317059@163.com
基金资助:
河北省卫生厅课题——探讨血浆同型半胱氨酸水平与不同类型脑梗死患者静脉溶栓预后的相关性（20181647）

Research Progress of Arterial Embolectomy Therapy Guided by CT Perfusion

Received:2018-01-18 Online:2018-06-20 Published:2018-06-20

摘要/Abstract

摘要：

脑梗死具有发病率、致死率及致残率高的特点，其治疗方法多样，主要包括药物治疗、介入治疗和外科手术治疗。现动脉取栓治疗已广泛应用于临床。本文对脑梗死的成因、计算机断层扫描灌注成像概念及应用、动脉取栓研究进展进行综述。

文章导读： 本文就脑CT灌注成像对动脉取栓的指导作用进行综述，旨在增加临床医生在治疗上的选择。

关键词: 计算机断层扫描灌注成像; 大动脉闭塞型脑梗死; 动脉取栓

Abstract:

Cerebral infarction possesses the characteristics of high morbidity, mortality and disability rate. The methods for its therapy are diversified, mainly including drug therapy, interventional therapy and surgical therapy. Nowadays, arterial embolectomy therapy has been applied into clinical practice widely. In this paper, the causes for cerebral infarction, CT perfusion imaging concept and application, and the research progress of arterial embolectomy are reviewed.

Key words: CT perfusion; Large artery occlusive cerebral infarction; Arterial embolectomy

王天罡, 宋彦丽, 朱弘璐, 李朝, 林杰, 武一平. CTP指导下脑梗死取栓治疗的研究进展[J]. 中国卒中杂志, 2018, 13(06): 626-630.

WANG Tian-Gang, SONG Yan-Li, ZHU Hong-Lu, LI Zhao, LIN Jie, WU Yi-Ping. Research Progress of Arterial Embolectomy Therapy Guided by CT Perfusion[J]. Chinese Journal of Stroke, 2018, 13(06): 626-630.

参考文献

[1] 李昂，丁里. CT灌注成像在缺血性脑血管病诊断及

治疗中应用的研究进展[J]. 山东医药，2016，56（30）：

110-112.

[2] SHANKAR J J，LANGLANDS G，DOUCETTE

S，et al. CT perfusion in acute stroke predicts final

infarct volume-inter-observer study[J]. Can J Neurol

Sci，2016，43（1）：93-97.

[3] SHARP F R，LU A，TANG Y，et al. Multiple

molecular penumbras after focal cerebral ischemia[J].

J Cereb Blood Flow Metab，2000，20（7）：1011-1032.

[4] HU M J，LIU Y，DENG C G，et al. Heat shock

protein 70 expression in the brain of rats with

cerebral infarction after receiving vascular

endothelial growth factor 165 gene therapy[J]. Di Yi

Jun Yi Da Xue Xue Bao，2003，23（7）：720-722.

[5] NICOLI F，LEFUR Y，DENIS B，et al.

Metabolic counterpart of decreased apparent

diffusion coefficient during hyperacute ischemic

stroke：a brain proton magnetic resonance

spectroscopic imaging study[J/OL]. Stroke，2003，

34（7）：e82-e87. https：//doi.org/10.1161/01.

STR.0000078659.43423.0A.

[6] HEISS W D，GROND M，THIEL A，et al.

Ischaemic brain tissue salvaged from infarction with

alteplase[J]. Lancet，1997，349（9065）：1599-1600.

[7] KAMALIAN S，KAMALIAN S，KONSTAS

A A，et al. CT perfusion mean transit time maps

optimally distinguish benign oligemia from true

"at-risk" ischemic penumbra，but thresholds vary

by postprocessing technique[J]. AJNR Am J

Neuroradiol，2012，33（3）：545-549.

[8] DABABNEH H，BASHIR A，GUERRERO W

R，et al. Mean transit time on Aquilion ONE and

its utilization in patients undergoing acute stroke

intervention[J]. J Vasc Interv Neurol，2014，7（5）：

73-81.

[9] 中华医学会神经病学分会. 中国急性缺血性脑卒中

诊治指南2014[J]. 中华神经科杂志，2015，48（4）：

246-257.

[10] National Institute of Neurological Disorders

and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke[J].

N Eng J Med，1995，333（24）：1581-1587.

[11] SENERS P，TURC G，MAÏER B，et al. Incidence

and predictors of early recanalization after

intravenous thrombolysis：a systematic review and

meta-analysis[J]. Stroke，2016，47（9）：2409-2412.

[12] GOYAL M，MENON B K，VAN ZWAM W H，et

al. Endovascular thrombectomy after large-vessel

ischaemic stroke：a meta-analysis of individual

patient data from five randomised trials[J]. Lancet，

2016，387（10029）：1723-1731.

[13] RODRIGUES F B，NEVES J B，CALDEIRA D，et

al. Endovascular treatment versus medical care alone

for ischaemic stroke：systematic review and metaanalysis[

J/OL]. BMJ，2016，353：1754. http：//dx. doi.

org/10. 1136/bmj. i1754

[14] BRODERICK J P，PALESCH Y Y，DEMCHUK A

M，et al. Endovascular therapy after intravenous t-PA

versus t-PA alone for stroke[J]. N Engl J Med，2013，

368（10）：893-903.

[15] CICCONE A，VALVASSORI L，NICHELATTI

M，et al. Endovascular treatment for acute ischemic

stroke[J]. N Engl J Med，2013，368（10）：904-913.

[16] KIDWELL C，JAHAN R，GORNBEIN J，et al.

A Trial of Imaging Selection and Endovascular

Treatment for Ischemic Stroke[J]. N Engl J Med，

2013，368（10）：914-923.

[17] BERKHEMER O A，FRANSEN P S，BEUMER D，

et al. A randomized trial of intraarterial treatment

for acute ischemic stroke[J]. N Engl J Med，2015，372

（1）：11-20.

[18] GOYAL M，DEMCHUK A M，MENON B K，et

al. Randomized assessment of rapid endovascular

treatment of ischemic stroke[J]. N Engl J Med，2015，

372（11）：1019-1030.

[19] CAMPBELL B C，MITCHELL P J，KLEINIG T J，

et al. Endovascular therapy for ischemic stroke with

perfusion-imaging selection[J]. N Engl J Med，2015，

372（11）：1009-1018.

[20] SAVER J L，GOYAL M，BONAFE A，et al. Stentretriever

thrombectomy after intravenous t-PA vs.

t-PA alone in stroke[J]. N Engl J Med，2015，372

（24）：2285-2295.

[21] JOVIN T G，CHAMORRO A，COBO E，et al.

Thrombectomy within 8 hours after symptom onset

in ischemic stroke[J]. N Engl J Med，2015，372（24）：

2296-306.

[22] GOYAL M，MENON B K，VAN ZWAM W H，et

al. Endovascular thrombectomy after large-vessel

ischaemic stroke：a meta-analysis of individual

patient data from five randomised trials[J]. Lancet，

2016，387（10029）：1723-1731.

[23] STRBIAN D，SOINNE L，SAIRANEN T，et

al. Ultraearly thrombolysis in acute ischemic

stroke is associated with better outcome and lower

mortality[J]. Stroke，2010，41（4）：712-716.

[24] KIM J T，PARK M S，NAM T S，et al.

Thrombolysis as a factor associated with favorable

outcomes in patients with unclear-onset stroke[J].

Eur J Neurol，2011，18（7）：988-994.

[25] HACKE W，FURLAN A J，AL-RAWI Y，et al.

Intravenous desmoteplase in patients with acute

ischaemic stroke selected by MRI perfusiondiffusion

weighted imaging or perfusion CT（DIAS-

2）：a prospective，randomised，double-blind，

placebo-controlled study[J]. Lancet Neurol，2009，8

（2）：141-150.

[26] GASPAROTTI R，GRASSI M，MARDIGHIAN D，

et al. Perfusion CT in patients with acute ischemic

stroke treated with intra-arterial thrombolysis：

predictive value of infarct core size on clinical

outcome[J]. AJNR Am J Neuroradiol，2009，30（4）：

722-727.

[27] DABABNEH H，BASHIR A，GUERRERO W

R，et al. Mean transit time on Aquilion ONE and

its utilization in patients undergoing acute stroke

intervention[J]. J Vasc Interv Neurol，2014，7（5）：

73-81.

[28] HEIT J J，WINTERMARK M. Imaging selection for

reperfusion therapy in acute ischemic stroke[J]. Curr

Treat Options Neurol，2015，17（2）：332.

CTP指导下脑梗死取栓治疗的研究进展

Research Progress of Arterial Embolectomy Therapy Guided by CT Perfusion

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