ABSTRACT
@#Objective To study the clinical diagnosis value of the combination application of CT perfusion(CTP) and CT angiography (CTA) in cerebrovascular diseases. Methods 20 patients suspected of cerebrovascular diseases（CVD） were examined with CTP and CTA. All the CTA data were send to 3D post processing card for MIP, SSD and VR reconstruction. Perfusion data were analyzed by CT perfusion package. The absolute TTP, MTT, CBV, CBF values and the relative value between normal and pathological sides were calculated.Results Low perfusion which indicated the prophase of ischemia infarction were detected in 15 cases, 12 cases were located in MCA area, and 10 of them the stenosis of responsible arteries were demonstrated. The degree of the vessel stenosis can be evaluated exactly by CTA source images. Other 5 cases were located in the area of PCA and no positive detection in CTA examination.Conclusion Combined application of CTP and CTA can finish two examinations at the same time in the fast and economic way. Both the hemodynamics changing and the morphology of the vessels were demonstrated which providing omnidirectional pathophysiological information for clinical diagnosis and therapy.
ABSTRACT
Objective To investigate the progress of pathology of the perihematomal tissue, and to study the relationship between the pathology and the changes of regional cerebral blood flow after intracerebral hemorrhage(ICH) in rats. Methods ICH was produced by microinjection of fresh autologous blood into the right caudatum in rats. CT perfusion imaging and computer-aided mapping in measurements of regional cerebral blood flow adjacent to the hematomas were performed in seventy SD rats at 1h, 3h, 6h, 12h, 24h, 48h and 72h respectively after the ICH. The parameters of regional cerebral blood flow(rCBF), regional cerebral blood volume(rCBV) and mean transit time(MTT) were calculated respectively. After the CT examination, the histopathological examination of TTC, HE and ultrastructure staining were carried out. Results The gradient of perihematomal hypoperfusion was revealed on CT perfusion maps. The rCBF and rCBV around the hematomas reduced pronouncedly, and the MTT delayed. TTC staining did not show infarction around the hematoma. Histopathological study demonstrated the astrocytic swelling and neuronal degeneration in the peri-ICH regions. The inflammory cell infiltration and capillaries hyperplasia were also observed around the ICH. Under the electronic microscope, the pathological changes of ultrastructure were revealed. In the early stage of ICH, there existed swelling of astrocytes, loosing of myelin sheath lamina, but no clear changes occurred in neurons. With the delay of ICH, the cellular injury around hematomas exacerbated progressively, more swelling of astrocytes, slight degeneration of neurons and local fragmentation of myelin sheath lamina were observed.Conclusion The perihemorrhagic and distant ischemic injury can be induced by the pronounced reduction of cerebral blood flow in the early stage of ICH. The cellular injury around hematomas exacerbates progressively in the acute stage of ICH. There is a perihematomal penumbra affecting multiple mechanisms of cellular injury.