評估在64切電腦斷層掃描儀使用床板跳曳技術延伸腦血流灌注攝影掃描範圍的可行性

腦部電腦斷層灌注掃描的主要侷限是在Z軸上所能包含的範圖與額外增加的輻射劑量。使用床板跳曳技術（toggling table technique）可以將64切電腦斷層檢查掃描32mm的涵蓋範圍增加到兩倍成為64mm而有利於偵測病灶，本研究的目的在於評估使用低劑量電腦斷層灌注掃描和延伸掃描範圖檢測灌流異常的可行性。共納入27位病人在急診接受電腦斷層灌注掃描，利用電腦斷層床板跳曳技術在64切電腦斷層掃描，在低劑量電腦斷層掃描條件下，等效輻射劑量為1.14毫西弗（mSv）。我們對灌注參數進行了分析並以後續追蹤的電腦斷層和磁振造影檢查來證實是否為真實灌注異常。結果3例患者有急性梗塞而其平掃電腦斷層影像中仍未見衰減變化。與對側健康腦實質相比，梗塞區的平均腦血容量減少14.4%，腦血流量降低43.8%，平均通過時間增加37.4%，而達到峰值時間增加了26.7%。顯示電腦斷層灌注掃描應用床板跳曳技術和低劑量協議對早期腦梗塞的檢測非常有用。

關鍵字

64切電腦斷層；床板跳曳技術；電腦斷層灌注檢查；腦血流灌注

並列摘要

Limited coverage in the Z-axis and additional radiation dose were critical drawback of computed tomography perfusion (CTP) of brain. Using the toggling table technique, the 32 mm coverage volume data acquired on the 64-slice computed tomography scanner could be doubled to 64 mm coverage and benefit lesion detection. The purpose of this study was to evaluate the feasibility of CTP with extended coverage in low-dose radiation for assessment of perfusion abnormality. Twenty-seven patients who received CTP study in emergency department were included. CTP was performed with toggling table technique in 64-slice computed tomography (CT), and the equivalent dose was 1.14 mSv in low-dose protocol. The perfusion parameters were analyzed and perfusion abnormality was confirmed with follow-up magnetic resonance image or CT study. Three patients had acute infarctions without attenuation change on unenhanced CT scan. Compared with contralateral healthy brain, the mean cerebral blood volume of infarction area was reduced 14.4%, the cerebral blood flow was reduced 43.8%, mean transit time was increased 37.4%, and time to peak was increased 26.7%. CTP with toggling table technique in low-dose protocol is useful for early infarction detection.

並列關鍵字

64-slice MDCT ； Toggling table technique ； computed tomography perfusion ； cerebral blood perfusion

國際替代計量

評估在64切電腦斷層掃描儀使用床板跳曳技術延伸腦血流灌注攝影掃描範圍的可行性

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