宝石能谱CT多模态技术诊断急性缺血性脑卒中

目的:探索宝石能谱CT多模态检查在急性缺血性脑卒中的临床应用效果。方法:回顾性分析本院58例急性缺血性脑卒中患者能谱CT平扫、CTA及CTP图像，观察多模态64排能谱CT在诊断急性缺血性脑卒中的作用。结果:①能谱CT平扫患侧脑碘（水）值、水（碘）值含量明显低于健侧，结果存在显著差异，其余能谱曲线斜率及能谱CT值两个指标无明显差异；②能谱CT动态CTP显示58例患者中，55例（94.83％）患者存在灌注异常，患侧和对侧的 MTT、TTP及CBF等指标都存在明显差异，CBV无明显差异；③利用CTP原始图像重建的CTA原始轴位图显示颅内血管4～5级分支血管清晰，三维重建图显示血管结构清晰，可达到诊断要求。结论:能谱CT多模态技术在急性缺血性脑卒中诊断中，可快速发现梗死责任血管、分辨梗死及缺血区，检查速度快、参数多，具有重要临床价值。 

Gemstone Energy Spectral CT Multimodal Technique for Diagnosis of Acute Ischemic Stroke

Objective: To explore the clinical application of multi-modal gemstone spectral CT in acute ischemic stroke. Methods: The spectral noncontrast CT, CTA and CTP images of 58 patients with acute ischemic stroke in our hospital were retrospectively analyzed, and the effect of multi-modal 64 spectral CT in the treatment of ischemic stroke was observed. Results: (1) The iodine (water) value and water (iodine) content of the affected side were significantly lower than those of the contralateral side in spectral noncontrast CT, which showed significant difference while there were no significant differences in the other two indexes of slope of energy spectrum curve curve and spectral CT value. (2) Spectral CT dynamic CTP showed that among the 58 patients, 55 (94.83%) patients had abnormal perfusion, and there were significant differences in MTT, TTP, CBF and other indexes between the affected side and the contralateral side, but no significant difference showed in CBV. (3) The original axial CTA image reconstructed by the original CTP images showed clear vessels of grade 4-5 branches of intracranial vessels. The three-dimensional reconstruction image showed clear vascular structure and slightly rough wall, which could meet the diagnostic requirements. Conclusion: In the dignosis of acute ischemic stroke, multi-modal spectral CT technology has important clinical value, which not only can quickly locate the infarct responsible vessels, distinguish the infarct and ischemic areas, and also holds the advantages of fast examination speed and many parameters.