The value of combined application of CT perfusion imaging and CT angiography in the diagnosis of hyperacute ischemic cerebrovascular disease / 临床神经病学杂志

ABSTRACT

Objective To evaluate the value of combined application of computed tomography perfusion imaging(CTPI)and CT angiography(CTA) in the diagnosis of hyperacute ischemic cerebrovascular disease.Methods 46 patients with hyperacute ischemic cerebrovascular disease(onset within 6 hours) were examined by conventional CT , CTPI and CTA.Results Conventional CT scan showed low density signal in 5 of 46 patients. CTPI revealed normal perfusion in 16 patients and hypoperfusion in 30 patients. 27 patients existed stenosis or occlusion of middle cerebral arteries(MCA) and anterior cerebral arteries(ACA) by CTA. CTA also showed obvious slight MCA in 2 cases and normal image in 17 cases. 25 cases with large or moderate cerebral infarction volume were confirmed by CTPI as having ischemic hypoperfusion lesions and stenosis or occlusion of arteries by CTA. In 9 cases with small cerebral infarction volume, CTPI revealed perfusion defect in 5 patients and CTA displayed stenosed arteries in 2 patients. CTPI of 12 patients with TIA were normal. But CTA showed remarkable slight MCA and more blood vessel network in its distal segment in 2 of 12 patients.Conclusion combined application of CTPI and CTA can detect hyperacute ischemic lesion at far more early stage. They are helpful in differentiation TIA from infarcts with different volumes.