於帆,ArmanSha,单艺,郭道德,张苗,马青峰,卢洁.醒后卒中与时间窗明确卒中多模态CT表现[J].中国医学影像技术,2022,38(12):1769~1773
醒后卒中与时间窗明确卒中多模态CT表现
Multimodality CT characteristics of wake-up stroke and onset clear stroke
投稿时间:2022-07-30  修订日期:2022-10-18
DOI:10.13929/j.issn.1003-3289.2022.12.003
中文关键词:  卒中  体层摄影术,X线计算机  灌注成像  血管造影术
英文关键词:stroke  tomography, X-ray computed  perfusion imaging  angiography
基金项目:国家自然科学基金(82130058)、北京市自然科学基金(Z190014)。
作者单位E-mail
於帆 首都医科大学宣武医院放射与核医学科, 北京 100053
磁共振成像脑信息学北京市重点实验室, 北京 100053 
 
ArmanSha 首都医科大学宣武医院放射与核医学科, 北京 100053
磁共振成像脑信息学北京市重点实验室, 北京 100053 
 
单艺 首都医科大学宣武医院放射与核医学科, 北京 100053
磁共振成像脑信息学北京市重点实验室, 北京 100053 
 
郭道德 首都医科大学宣武医院放射与核医学科, 北京 100053
磁共振成像脑信息学北京市重点实验室, 北京 100053 
 
张苗 首都医科大学宣武医院放射与核医学科, 北京 100053
磁共振成像脑信息学北京市重点实验室, 北京 100053 
 
马青峰 首都医科大学宣武医院神经内科, 北京 100053  
卢洁 首都医科大学宣武医院放射与核医学科, 北京 100053
磁共振成像脑信息学北京市重点实验室, 北京 100053 
imaginglu@hotmail.com 
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中文摘要:
      目的 对比观察醒后卒中(WUS)与时间窗明确卒中(OCS)患者的多模态CT表现。方法 纳入因急性缺血性卒中而接受多模态CT检查的36例WUS患者(WUS组)与41例OCS患者(OCS组,起病时间<6 h),均经头颈部CT血管造影证实存在前循环大血管闭塞。采用Alberta卒中项目早期CT评分(ASPECTS)评价平扫CT所示早期脑缺血改变。将CT灌注(CTP)存在脑血流量(CBF)与脑血容量(CBV)不匹配区域认定为缺血半暗带,采用ASPECTS评价异常灌注范围(CBF-ASPECTS、CBV-ASPECTS)。结果 WUS组与OCS组平扫CT中位ASPECTS均为8.0分,差异无统计学意义(P>0.05)。27例(27/36,75.00%) WUS患者、30例(30/41,73.17%) OCS患者CTP存在缺血半暗带。WUS组与OCS组中位CBF-ASPECTS分别为3.0分及2.0分,CBV-ASPECTS均为6.0分,差异均无统计学意义(P均>0.05)。结论 WUS与起病6 h内OCS的多模态CT表现相似。
英文摘要:
      Objective To comparatively analyze multimodality CT characteristics of patients with wake-up stroke (WUS) or onset clear stroke (OCS). Methods Totally 36 WUS patients (WUS group) and 41 OCS patients (OCS group, onset time<6 h) with occlusion of large vessels in the anterior circulation confirmed by head and neck CT angiography and underwent multimodal CT examination due to acute ischemic stroke were enrolled. Alberta stroke program early CT score (ASPECTS) was used to evaluate early cerebral ischemic changes shown on plain CT. The mismatch between cerebral blood flow (CBF) and cerebral blood volume (CBV) on CTP was recognized as penumbra. Abnormal perfusion ranges (CBF-ASPECTS, CBV-ASPECTS) were evaluated with ASPECTS. Results The median ASPECTS on plain CT of WUS group and OCS group were both 8.0 (P>0.05). Ischemic penumbra was found in 27 (27/36, 75.00%) WUS patients and 30 (30/41, 73.17%) OCS patients. The median CBF-ASPECSTS was 3.0 in WUS group and 2.0 in OCS group, respectively, while CBV-ASPECTS were both 6.0 in 2 groups. There was no significant difference of median CBF-ASPECSTS nor CBV-ASPECTS between groups (both P>0.05). Conclusion Multimodal CT characteristics of WUS were similar to those of OCS within 6 h of onset.
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