The Preliminary Study Of Xenon-CT In Diagnosis And Treatment For Ischemic Cerebrovascular Disease

Ischemic cerebrovascular disease is a frequent and multiple disease which seriously endangers mankind's health and have a high attack rate, a high death rate, a high handicapping rate and a high relapse rate. Therefore strengthening the research of ischemic cerebrovascular disease, raising diagnosis and treatment level for it endlessly, are singificant. Some interventional therapies, for example thrombolysis and stent therapy, have been evolved these years for the treatment and prevention of the ischemic cerebrovascular disease, and have maken a certain progress for saving the ischemic penumbra and improving the patients'prognosis. At present, a brief 3 hours duration of stroke is defined as the best therapeutic window, or at least 6 hours, but the ischemic penumbra has individual difference, so it's inaccurate and subjective. The standards of whether Vascular stenosis requiring treatment is the degree of stenosis were 70% who has a little or no clinical symptoms. The degree of obvious clinical symptoms are 50%. Because the various effect of ischemic penumbra and the different degree of Vascular stenosis, it can not accurately determine the existence of cerebral ischemia and the ischemic level.Xe-CT technology can provide quantitative, repeated, partial or whole cerebral blood flow data, cerebrovascular reserve and collateral circulation. Furthermore, the images of the cerebral blood flow is directly connected with the anatomy of the brain, and it is greatsignificance on diagnosis and treatment for ischemic cerebrovascular disease. Analyzed the clinical patient's information of Ischemic cerebrovascular disease from May 2005 to April 2007, the neurology of First Hospital of Jilin University. Among the total, three patients had Xe-CT examination in six hours, 12 patients with TCD screening and MRA were confirmed serious vascular stenosis berore Xe-CT examination . Determined their cerebral blood flow, and then choose the treatment programs. Discussion Xe-CT perfusion imaging values of prognosis and guiding treatment in ischemic cerebrovascular disease.The results:①Among the three patients with acute ischemic cerebrovascular disease patients, the cerebral blood flow of pathological side were lower than the contralateral normal brain tissue. One patient ischemic cerebral blood flow was 10~20ml/(100g·min), so we can illustrate there are reversible ischemic penumbra.Through thrombolytic therapy, the clinical symptoms improved; The other 2 patients's ischemic cerebral blood flow were lower than 10ml/(100g·min), who had irreversible necrosis, were given conservative treatment;②Among 12 cases of patients with vascular stenosis, Xe-CT showed that 5 patients's cerebral blood flow were lower than contralateral brain tissue before stent treatment. Three cases of ischemic regional blood flow is generally higher than that of 10ml/(100g·min), so we choose a stent in the treatment. Clinical symptoms were improved. After review Xe-CT inspection, we couldsee the ischemic regional cerebral blood flow were significantly improved; Another two cases of ischemic regional cerebral blood flow were lower than 10ml/ ( 100g·min ) , who were given clinical conservative treatment. 3 patients Xe-CT showed that the cerebral blood flow of two sides had no significant regional differences; 2 cases of the patients had perfusion conditions exist, the supply of vascular stenosis regional cerebral blood flow is higher than the contralateral regional image. These five patients were givenn medicine conservative treatment.Above all, we indicate: Xe-CT examination has high sensitivity due to cerebral ischemia, it is the important method of early detection of cerebral infarction, and the scope and extent of ischemic lesions; choosing Xe-CT inspection before thrombolytic therapy program can help clearing the scope and extent of ischemia, identifiing whether ischemic tissue is reversible, deciding the early treatment time window of individual acute cerebrovascular disease, provding objective indication for thrombolytic therapy. Xe-CT inspection before Cerebral vascular restenosis stent treatment can contribute to the assessment the condition of patients autologous regulation and cerebrovascular reserve, determine treatment plan and estimate prognosis.