能谱CT对急性脑梗死介入术后颅内异常高密度影的鉴别诊断分析

doi:10.12114/j.issn.1007-9572.2018.00.124

摘要/Abstract

摘要： 背景急性脑梗死介入术后，有极少数患者合并脑出血转化。采用常规CT检查时，介入术中使用的对比剂与脑出血转化均表现为高密度，二者不能被及时有效鉴别，而关于能谱CT鉴别二者的研究也鲜见报道。目的　探讨能谱CT对急性脑梗死介入术后颅内异常高密度影的鉴别诊断价值。方法　回顾性分析河南省中医院2014年5月—2017年10月收治的21例急性脑梗死介入术后即刻行能谱CT平扫出现颅内异常高密度影的急性脑梗死患者图像，以术后24 h常规CT复查结果为标准，将21例颅内异常高密度影分为对比剂渗出组（渗出组，11例）和脑出血转化组（出血组，10例），分别测量各组颅内异常高密度影及其周围正常脑白质的CT值、水（碘）基值、碘（水）基值，计算这3个观察指标的相对值，并比较两组的差异。结果　两组颅内异常高密度影CT值比较，差异无统计学意义（P>0.05）；渗出组水（碘）基值小于出血组，碘（水）基值大于出血组（P<0.05）。两组颅内异常高密度影周围正常脑白质CT指标比较，差异无统计学意义（P>0.05）。两组CT值相对值比较，差异无统计学意义（P>0.05），在CT扫描图上均表现为相似的高密度；渗出组水（碘）基值相对值小于出血组（P<0.05），在水（碘）基图上，对比剂渗出表现为等低密度，出血表现为高密度；渗出组碘（水）基值相对值大于出血组（P<0.05），在碘（水）基图上，对比剂渗出表现为高密度，出血表现为等低密度。结论　能谱CT可以通过碘-水基物质对图对急性脑梗死介入术后CT图像上出现的颅内异常高密度影进行及时有效地鉴别诊断。

关键词: 脑梗死；体层摄影术, 螺旋计算机；放射学, 介入性；碘-水基图

Abstract: Background　There are a few patients with hemorrhagic transformation after interventional procedure for acute cerebral infarction.However，on conventional CT，hemorrhagic transformation and contrast exudation used in interventional procedure are hyperdensity，which can not be identified effectively in time，and the study on the identification of the two by Spectral CT is rarely reported.Objective　To evaluate the value of differential diagnosis of intracranial hyperdensity after interventional procedure for acute cerebral infarction by spectral CT.Methods　The hyperdensity CT images which immediately obtained in 21 patients with acute cerebral infarction in Henan Traditional Chinese Medicine Hospital between May 2015 to October 2017，after interventional procedure were analyzed retrospectively.According to the results of conventional CT 24 hours after interventional procedure，21 cases were divided into two groups：contrast exudation group（n=11） and hemorrhagic transformation group（n=10）．CT value，iodine （water） and water（iodine） based value，and relative value between these values and the value of periventricular normal-appearing white matter were measured in each group，and the difference between the two groups were compared.Results　There was no significant difference in the CT value of intracranial hyperdensity between the two groups （P>0.05）．Water （iodine） value in exudation group was lower than that in hemorrhage group，and the iodine （water） value in exudation group was higher than that in hemorrhage group（P<0.05）．There was no significant difference in CT indexes between the two groups（P>0.05）．There was no significant difference in the relative value between the two groups （P>0.05），and CT density images showed similar high density．The relative value of the water（iodine） in exudation group was lower than that of the hemorrhage group（P<0.05）．On the water（iodine） images，the contrast extravastion showed low density，and the hemorrhage showed high density．The relative value of iodine（water） value of the contrast extravasation group was larger than that of hemorrhage group（P<0.05）．On the iodine （water） images，the contrast extravasation showed high density，and the hemorrhage showed low density.Conclusion　The spectral CT can be used to differentiate intracranial abnormal high density after interventional procedure of acute cerebral infarction in a timely and effective manner.

Key words: Brain infarction；Tomography, spiral computed；Radiology, interventional；Iodine-water based image

孙瑞,葛英辉. 能谱CT对急性脑梗死介入术后颅内异常高密度影的鉴别诊断分析[J]. 中国全科医学, 2019, 22(6): 731-734. DOI: 10.12114/j.issn.1007-9572.2018.00.124.
SUN Rui,GE Yinghui. Differential Diagnosis of Intracranial Hyperdensity after Interventional Procedure for Acute Cerebral Infarction by Spectral CT　[J]. Chinese General Practice, 2019, 22(6): 731-734. DOI: 10.12114/j.issn.1007-9572.2018.00.124.

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