64 slice Spiral CT Cerebral Perfusion Imaging for Evaluation of Cerebral Hemodynamics Before and After Thrombolytic Therapy in Acute Cerebral Infarction

Objective To explore the value of 64-slice spiral CT cerebral perfusion imaging (CTP) in evaluating the thrombolytic therapy in patients with acute cerebral infarction. Materials and Methods Conventional plain CT and CTP were performed on 20 patients with acute cerebral infarction within 3 to 10 hours after onset of symptom. 16 patients underwent intravenous thrombolysis and 4 patients underwent intra-arterial thrombolysis. All patients were reexamined cerebral plain CT and CTP after thrombolysis. Qualitative and quantitative analysis of the cerebral perfusion parameters such as cerebral blood flow (CBF) ,cerebral blood volume (CBV) and time to peak (TTP) were carried out on CTP images before and after thrombolytic therapy. Results Results of conventional plain CT were normal in 15 cases and early infarction signs were showed in 5 cases. However, abnormal perfusion changes corresponding to clinical symptoms were all found in 20 cases, including CBF and CBV decreased, TTP delayed. Follow-up CTP showed that the cerebral perfusion improved in 15 cases after thrombolysis, including the extent of abnormal perfusion reduced, CBF and CBV increased, TTP was delayed. The hyperperfusion of ischemic lesion was observed in 2 cases. The extent of abnormal perfusion expanded, CBF and CBV decreased, TTP delayed even more than those before thrombolysis were found in 3 cases. There was statistically significant difference between the CBF and TTP on ischemic marginal region before and after thrombolysis (P0.05). However, there was no statistically significant difference between the CBF and CBV on ischemic central region before and after thrombolysis (P0.05). Conclusion64-slice spiral CTP can depict detailed hemodynamic information before and after thrombolysis, and provide important basis for evaluating the effect of thrombolytic therapy in patients with acute cerebral infarction.