中国卒中杂志 ›› 2017, Vol. 12 ›› Issue (08): 702-705.DOI: 10.3969/j.issn.1673-5765.2017.08.009

• 专题综述 • 上一篇    下一篇

多模式CT对卒中患者血脑屏障完整性和侧支循环的评估价值

张佳慧,徐运   

  1. 210008 南京南京大学医学院附属鼓楼医院神经内科
  • 收稿日期:2017-05-10 出版日期:2017-08-20 发布日期:2017-08-20
  • 通讯作者: 徐运 xuyun20042001@aliyun.com
  • 基金资助:

    国家重点研发计划重点专项(2016YFC1300500-504)
    江苏省科技厅医学重点项目(BE20166610)
    江苏省医学重点学科(ZDXKA2016020)

The Value of Multimodal CT in Assessing Blood-brain Barrier and Collateral Circulation in Patients with Acute Ischemic Stroke

  • Received:2017-05-10 Online:2017-08-20 Published:2017-08-20

摘要:

多模式计算机断层扫描(computed tomography,CT)对急性缺血性卒中患者的重要性逐 渐引起临床医生的重视,在脑缺血超急性期,CT平扫可对脑出血或其他脑部疾病进行鉴别,CT血管 造影可评估血管梗死部位和侧支循环状态,CT灌注成像可以通过毛细血管的实际灌注情况来评估 脑组织的活力,并通过计算血脑屏障的表面通透性(permeability surface,PS)判断血脑屏障的完整 性,进一步指导临床医生溶栓及血管性治疗方案的制定,也可以预测卒中后患者发生出血转化的风 险。临床诊疗过程中,结合多模式CT提供的信息,可对急性缺血性卒中患者出现出血转化和临床预后 进行全面评估。

文章导读: 多模式计算机断层扫描可提供急性卒中患者血管形态、血流动力学信息,也可有效预测患者临床预后。

关键词: 多模式计算机断层扫描; CT血管造影; CT灌注成像; 血脑屏障; 侧支循环

Abstract:

The importance of multimodal computed tomography (CT) scans for patients with acute ischemic stroke has been paid more and more attention by clinicians. In the acute phase of cerebral ischemia, CT scan can be used to identify cerebral hemorrhage or other brain disease. CT angiography can be used to evaluate the location of infarction and collateral circulation. CT perfusion imaging can provide clinicians with pathophysiological information in hyperacute cerebral ischemic. Measurement of parenchymal perfusion at the capillary level can be used to characterize tissue viability. Further, CT perfusion is useful for the detection of blood brain barrier disturbances with the permeability surface (PS) area product parameter. In the process of clinical diagnosis and treatment, the information provided by Multimodal CT could be used for comprehensive assessment of hemorrhagic transformation and clinical prognosis for patients with acute ischemic stroke.

Key words: Multimodal CT; CT angiography; CT perfusion; Blood-brain barrier; Collateral circulation