Diagnosis And Application Value Of CTA In Patients With Massive Cerebral Infarction

ObjectiveTo investigate the diagnosis and application value of CTA in patients with massive cerebral infarction.MethodsAll the patients in this study went to the hospital after the CT scan,the head and neck CTA examination can be completed in the 2--48 hours after admission,and the imaging quality meets the requirements.Using a retrospective study,all patients were diagnosed with multislice spiral CT and CTA angiography.The instrument was SIEMENS:SOMATOM AS128 spiral CT instrument.The parameters of axial scan were set to130 KV voltage value(U),150 mA current value(I),5mm scanning layer thickness and spacing,and the parameter of enhanced scan was set as 130 KV.Voltage value(U),150 mA current value(I),and scan layer thickness,thin layer reconstruction and interval are 5mm,1.25 mm,0.7mm respectively,pitch is between 1.0-1.5.At the time of CTA diagnosis,the patients were given iodiproplol from the anterior elbow vein(Guangzhou branch of Bayer health care Co.,Ltd.,J20100027,50ml:31.17g)for injection of about100 mL,the injection rate was about 4mL/s,and the spiral volume scan was used,the delay time was between 18-22 seconds,ranging from the atlantooccipital joint level.The apex of the ventricle of the lateral ventricle.Note that all patients will be re examined by multi-slice spiral CT within two days after the final diagnosis.The collected data were sent to the workstation for image post-processing.The images were reconstructed(NPR),maximum density projection(MIP)and volume reconstruction(VR)and a series of two-dimensional and three-dimensional reconstruction techniques.The CTA diagnosis required the observation of intracranial and internal carotid arteries,including cerebrovascular imaging.Spiral CT angiography(CTA)mainly observed the 1-4 stages of internal carotid artery,including the extracranial segment,basilar artery,Will,s ring,anterior,middle and posterior arteries.Results1、In the location of stenosis or occlusion of large cerebral infarction patients,M1 segment lesions of middle cerebral artery were most common,followed by anterior cerebral artery lesions.2、Most of the stenotic arteries were non calcified plaques and mixed plaques.3 、 CTA diagnosis: the CTA diagnosis of 90 patients showed that the cerebral parenchyma part and range of the vascular supply was larger than that of CT plain scan.The specific manifestations were: 90 cases of large area cerebral infarction with multi-slice spiral CT angiography,35 cases of anterior cerebral artery disease(21 cases of occlusion,14 stenosis),and 50 cases of middle cerebral artery disease(closed).There were 37 cases of obstruction,13 cases of stenosis,3 cases of simultaneous occlusion of anterior and middle cerebral artery,and 2 cases of end occlusion of internal carotid artery.7 cases of suspected aneurysms were combined.The location of the cerebral parenchyma and the extent of infarction in the occlusion or stenosis were significantly larger than those seen in plain CT scan.ConclusionsThrough the analysis of spiral CT angiography to change the examination results of vascular imaging in patients with cerebrovascular disease,to understand the different clinical types of patients with cerebrovascular disease lesions,arterial stenosis,stenosis and arterial stenosis caused by plaque,the establishment of collateral circulation situation,further to fully understand the clinical features of cerebral vascular disease,contribute to the prevention and treatment of cerebrovascular disease.It is helpful for timely treatment of patients with acute massive cerebral infarction and has a positive guiding significance for improving the prognosis of patients.1、In the location of stenosis or occlusion of large cerebral infarction patients,M1 segment lesions of middle cerebral artery were most common,followed by anterior cerebral artery lesions.2、Most of the stenotic arteries were non calcified plaques and mixed plaques.3、The head and neck CTA can not display the cerebral infarction directly in the early stage,but the super early head and neck CTA vascular positive findings combined with the indirect signs of cerebral ischemia can establish the diagnosis of large area cerebral infarction and provide valuable information for thrombolytic,thrombolytic and surgical treatment.