320排CT全脑灌注成像在TIA诊断中的价值.pptx

1、Whole brain CT perfusion deficits using 320-detector-row CT scanner in TIA patients are associated with ABCD2 scoreInternational Journal of Neuroscience, 2014; 124(1): 5660Introduction01Methods02Results03Discussion04Conclusion05A transient ischemic attack (TIA) is considered a cerebral ischemic even

2、t without end organ damage or loss of brain tissue . Despite newer guidelines differentiating TIA from stroke, there remains controversy between a “time-based” and “tissue-based” definition of TIA . IntroductionResponsible blood vessels for internal carotid artery system of TIA patients mainly for h

3、emiplegia, aphasia and partial body feels obstacle and so on.Responsibility for vertebral artery vessels system mainly displays in the patients with TIA vertigo, double vision, difficulty swallowing, etcTIA inspection method 1. Blood rheologyWhole blood viscosity, plasma viscosity, hematocrit 2.Cere

4、brovascular Carotid ultrasound、 DSA、 Cerebral perfusion3.CervicalcheckCervical spine X-rayCTandMRI4.CTandMRIWith the exception of hemorrhagic disease。5.ElectrocardiogramTo rule out:Frequent atrial fibrillation, premature beat, old myocardial infarctionSeveral papers demonstrate the presence of DWI/A

5、DC changes in patients with TIA. Others contend that the somewhat reversible nature of DWI/ADC changes indicates that DWI/ADC may not be the ideal indicator of end organ tissue damage . However, recent evidence has demonstrated that there can be more than just brain ischemia or at least sustained is

6、chemia involved in an acute TIA, which complicates the idea of TIA without detectable tissue damage.DWI are not the bestBecause MRI diffusion weighted imaging information infers at least “potential infarction,” where tissue can no longer be saved, rather than ischemia, perfusion imaging either via M

7、RI or CT is used to determine tissue at risk but not yet infracted, also known as penumbra. Perfusion modalities give a better representation of penumbra or tissue at risk but have not infarcted .01 A recent study has demonstrated that a significant portion TIA patients have perfusion changes using

8、64 detector row partial brain perfusion studies . Additionally, whole brain perfusion, using higher detector row CT scanners, has not been noted in the literature which could be more sensitive in determining the proportion of TIA patients that have perfusion abnormalities.02Currently, the ABCD2 score is used as a predictive tool to determine TIA patients who are at highest risk of stroke post-TIA. As the ABCD2 score determines immediate and 3-month stroke risk after TIA based on presenting symptoms, it provides an additional marker of potential stroke risk.