The Application Of 640 Slice Whole Brain CT Perfusion In Crossed Cerebellar Diaschisis Of Acute Cerebral Infarction

Object: To investigate the significance of 640-slice whole brain CTP technique for diagnosing CCD after acute cerebral infarction.Materials and methods: 32 patients determined as acute cerebral infarction by the clinical were examined with whole brain CT perfusion scan using 640 slice volume CT scanner.Clinical factors included age,gender,time intervals from symptom onset were analyzed.By Drawing ROI of ischemic area in the perfusion pseudo-color maps manually,we acquired the measurement parameters of ischemic area and mirrored region of cerebral including relative cerebral blood flow(rCBF),relative cerebral blood volume(rCBV),mean transit time(MTT)and time to peak(TTP).The data of perfusion were collected and analyzed.The asymmetric index(AI)of brain and cerebellum was calculated.CCD was rated positive when a unilateral supratentorial infarction area appeared and an accompanying perfusion decrease was showed in the contralateral cerebellum on at least two sequential slices of CTP maps.All the patients were divided into two groups including CCD-positive group and CCD-negative group.The age,the time intervals from symptom onset and the degree of abnormal perfusion between the two groups were analyzed by the independent sample t-test.The perfusion parameters between the contralateral and ipsilateral cerebellum were analyzed by the two-tailed paired t-test.The correlation analysis between the degree of abnormal perfusion and the severity of CCD was analyzed using spearman correlation test.Results:1.14 in 32 patients were detected CCD(the positive rate was 43.8%).2.Among 14 CCD-positive patients,the corresponding brain tissue ischemic area were middle cerebral artery blood supply area in 10 cases(71.4%),anterior cerebral artery blood supply area in 1 case(7.1%),simple basal ganglia in 3 cases(21.4%).3.There was no significant difference between the positive group and the negative group(P>0.05)about age,the time intervals from symptom onset and the abnormal level of brain perfusion.4.Quantitative analysis found that the value of rCBF,rCBV and MTT of ipsilateral cerebellum and contralateral cerebellum in CCD-positive patients were significantly difference(P<0.05).5.There was no correlation between the abnormal level of supratentorial brain perfusion and the severity of CCD.Conclusion:1.The age,the time intervals from symptom onset and the abnormal level of brain perfusion was not associated with the occurrence of CCD.2.The rCBV,rCBF and MTT perfusion values in the contralateral cerebellar hemisphere were significantly decreased in patients with CCD positive after acute cerebral infarction.3.The severity of CCD was not associated with the abnormal level of supratentorial brain perfusion.