The Application Of Multimodal CT Examination In Acute Ischemic Stroke

Objective: To explore the advantages and clinical value of multimodal CT examination in the diagnosis of acute ischemic stroke.Methods: Patients with suspected stroke who were hospitalized in the emergency department of Chongqing Three Gorges Central Hospita from January 2017 to September 2017 were selected for multimodal CT examination.After treatment,CT scan,CT angiography(CTA)and Whole Brain CT perfusion(CTP)were obtained.The parameters of cerebral blood flow(CBF),cerebral blood volume(CBV),mean transit time(MTT)and the time to peak(TTP)were measured in infarct core,ischemic penumbra(IP)region and healthy mirror region.The infarct core area and IP were compared with each other,and the relative values of each perfusion parameter were analyzed.Statistical analysis of patients 4.5-9 hours and compare the perfusion changes of IP region with the treatment of thrombolytic and the normal treatment.Results: Multimodal CT examination revealed 91 cases of pre-infarction and cerebral infarction.Among them,42 cases with fresh infarction were found by plain CT scan,and 58 cases with abnormal arteries by CTA.CT perfusion results: There were 56 cases of pre-infarction and 35 cases with cerebral infarction.Among 35 cases of cerebral infarction,30 cases had different ranges of ischemic penumbra.There were statistically significant differences of CBF,MTT and TTP values in the IP region of 30 patients(P<0.05).There was no significant difference of CBV between the two sides(P>0.05),and CBF,CBV,MTT and TTP values in infarct core area were statistically significant(P<0.05).In 18 cases of patients 4.5-9h with IP,there were statistically significant differences in IP of rCBF,rTTP and rMTT before and after treatment in thrombolytic therapy(P<0.05),and the difference of rCBV was not statistically significant(P>0.05).There was statistically significant difference in the rCBF of the IP zone in conventional treatment before and after treatment(P<0.05).Compared with the treatment after thrombolytic therapy and routine treatment,the difference of rCBF,rTTP and rMTT was statistically significant(P<0.05),and the difference of rCBV was not statistically significant(P>0.05).Conclusion: Multimodal CT examination can detect hemodynamic changes and blood supply in the corresponding areas of patients with pre-infarction,and define the infarct core and ischemic penumbra,which has important value in guiding early clinical treatment.