[1]方 慧,徐浩洋,朱悦琦,等.C臂锥形束CT灌注在急性缺血性脑卒中诊治中的应用进展 [J].介入放射学杂志,2023,32(02):192-195.
 FANG Hui,XU Haoyang,ZHU Yueqi,et al.Advances in the application of C-arm cone beam CT perfusion for acute ischemic stroke[J].journal interventional radiology,2023,32(02):192-195.
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C臂锥形束CT灌注在急性缺血性脑卒中诊治中的应用进展


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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
32
期数:
2023年02
页码:
192-195
栏目:
综 述
出版日期:
2023-03-03

文章信息/Info

Title:
Advances in the application of C-arm cone beam CT perfusion for acute ischemic stroke
作者:
方 慧 徐浩洋 朱悦琦 程英升
Author(s):
FANG Hui XU Haoyang ZHU Yueqi CHENG Yingsheng.
Department of Interventional Radiology, Affiliated Sixth People’s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200233, China
关键词:
【关键词】 急性缺血性脑卒中C臂锥形束CT脑灌注成像临床应用
文献标志码:
A
摘要:
【摘要】 急性缺血性脑卒中(AIS)具有高致死致残率。脑组织缺血时间越长临床预后越差,尽早恢复缺血区血流灌注,挽救缺血半暗带一直是AIS诊治重点,而启动再灌注治疗前快速识别半定量缺血半暗带是影像学筛查核心内容。基于DSA设备的新兴断层成像C臂锥形束CT(CBCT)与传统CT相比更有利于实现AIS一站式诊治,明显缩短缺血组织再灌注时间,获得良好临床预后。然而由于现有设备硬件和算法限制,该技术目前尚未广泛应用于临床。本文就CBCT灌注技术在AIS相关成像方法、原理及其在临床诊治中应用进展作一综述。

参考文献/References:

[1] 王春娟,霍晓川,冀瑞俊,等. 急性缺血性卒中再灌注治疗医疗质量评价与改进专家建议[J]. 中国卒中杂志,2021,16:705- 715.
[2] Warner JJ, Harrington RA, Sacco RL, et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke[J]. Stroke, 2019, 50: 3331-3332.
[3] 刘 强,王永利,王征宇,等. 动静脉联合灌注替罗非班在非大血管闭塞急性缺血性脑卒中患者中的应用[J]. 介入放射学杂志,2019,28:1131-1135.
[4] Phipps MS, Cronin CA. Management of acute ischemic stroke[J]. BMJ, 2020, 368: l6983.
[5] 国家卫生健康委员会脑卒中防治工程委员会神经影像专业委员会,中华医学会放射学分会神经学组.脑血管病影像规范化应用中国指南[J]. 中华放射学杂志,2019,53:916-940.
[6] Potla N, Ganti L. Tenecteplase vs. alteplase for acute ischemic stroke: a systematic review[J]. Int J Emerg Med, 2022, 15: 1.
[7] Logallo N, Novotny V, Assmus J, et al. Tenecteplase versus alteplase for management of acute ischaemic stroke (NOR-TEST): a phase 3, randomised, open-label, blinded endpoint trial[J]. Lancet Neurol, 2017, 16:781-788.
[8] Goyal M, Menon BK, Van Zwam WH, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: a meta-analysis of individual patient data from five randomised trials[J]. Lancet, 2016, 387: 1723-1731.
[9] Wang Y, Li Z, Wang Y, et al. Chinese stroke center alliance: a national effort to improve healthcare quality for acute stroke and transient ischaemic attack: rationale, design and preliminary findings[J]. Stroke Vasc Neurol, 2018, 3: 256-262.
[10] Dong Q, Dong Y, Liu L, et al. The Chinese stroke association scientific statement: intravenous thrombolysis in acute ischaemic stroke[J]. Stroke Vasc Neurol, 2017, 2: 147-159.
[11] Saver JL, Goyal M, Bonafe A, et al. Stent-retriever thrombectomy after intravenous t-PA vs.t-PA alone in stroke[J]. N Engl J Med, 2015, 372: 2285-2295.
[12] 邱 凯,施海彬,祖庆泉,等. 院内急性缺血性脑卒中机械取栓治疗效果和预后因素分析[J]. 介入放射学杂志,2021,30:118-122.
[13] 周腾飞,朱良付,李天晓. 影响急性缺血性脑卒中血管内治疗预后的相关因素分析[J]. 介入放射学杂志,2017,26: 99-104.
[14] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组. 中国急性缺血性脑卒中诊治指南2018[J]. 中华神经科杂志,2018,51:666-682.
[15] 中华医学会影像技术分会. 急性脑卒中多层螺旋CT检查技术专家共识[J]. 中华放射学杂志,2020,54:839-845.
[16] Kauw F, Greving JP, Takx RAP, et al. Prediction of long-term recurrent ischemic stroke: the added value of non-contrast CT, CT perfusion, and CT angiography[J]. Neuroradiology, 2021, 63: 483-490.
[17] 孙静坤,曾勇明. C臂锥形束CT的基本理论及其在介入放射学中的应用[J]. 中国介入影像与治疗学,2013,10:641-644.
[18] Huang KM, Huang TC, Tsai CJ, et al. High-resolution gel dosimetry using flat-panel detector cone-beam computed tomography: preliminary study[J]. Appl Radiat Isot, 2010, 68: 607-609.
[19] Itokawa H, Okamoto N, Fujimoto M, et al. C-arm CT perfusion study using angiography system[J]. J Endovasc Ther, 2019, 13: 189-197.
[20] Gupta R, Cheung AC, Bartling SH, et al. Flat-panel volume CT: fundamental principles, technology, and applications[J]. Radiographics, 2008, 28: 2009-2022.
[21] Eckert M, Golitz P, Lucking H, et al. Optimized flat-detector CT in stroke imaging: ready for first-line use?[J]. Cerebrovasc Dis, 2017, 43: 9-16.
[22] Niu K, Yang P, Wu Y, et al. C-arm conebeam CT perfusion imaging in the angiographic suite: a comparison with multidetector CT perfusion imaging[J]. AJNR Am J Neuroradiol, 2016, 37: 1303-1309.
[23] Royalty K, Manhart M, Pulfer K, et al. C-arm CT measurement of cerebral blood volume and cerebral blood flow using a novel high-speed acquisition and a single intravenous contrast injection[J]. AJNR Am J Neuroradiol, 2013, 34: 2131-2138.
[24] Beuing O, Boese A, Kyriakou Y, et al. A novel technique for the measurement of CBF and CBV with robot-arm-mounted flat panel CT in a large-animal model[J]. AJNR Am J Neuroradiol,2014 ,35:1740-1745.
[25] Li Y, Garrett JW, Li K, et al.Time-resolved C-arm cone beam CT angiography(TR-CBCTA)imaging from a single short-scan C-arm cone beam CT acquisition with intra-arterial contrast injection[J]. Phys Med Biol, 2018, 63: 75001.
[26] Yang P, Niu K, Wu Y, et al. Evaluation of collaterals and clot burden using time-resolved C-arm conebeam CT angiography in the angiography suite: a feasibility study[J]. AJNR Am J Neuroradiol, 2017, 38: 747-752.
[27] Nicholson P, Cancelliere NM, Bracken J, et al. Novel flat-panel cone-beam CT compared to multi-detector CT for assessment of acute ischemic stroke: a prospective study[J]. Eur J Radiol, 2021, 138: 109645.
[28] Maier IL, Leyhe JR, Tsogkas I, et al. Diagnosing early ischemic changes with the latest-generation flat detector CT: a comparative study with multidetector CT[J]. AJNR Am J Neuroradiol, 2018, 39: 881-886.
[29] 冯聪聪,宣 晓,高 上,等. 血管造影锥形束CT重建算法中的滤波器设计研究[J]. 中国医学装备,2020,17:1-4.
[30] Shaker H, Khan M, Mulderink T, et al. The role of CT perfusion in defining the clinically relevant core infarction to guide thrombectomy selection in patients with acute stroke[J]. J Neuroimaging, 2019, 29: 331-334.
[31] Jiang B, Ball RL, Michel P, et al. Factors influencing infarct growth including collateral status assessed using computed tomography in acute stroke patients with large artery occlusion[J]. Int J Stroke, 2019, 14: 603-612.
[32] Becks MJ, Manniesing R, Vister J, et al. Brain CT perfusion improves intracranial vessel occlusion detection on CT angiography[J]. J Neuroradiol, 2019 ,46:124-129.
[33] Ukmar M, Degrassi F, Pozzi Mucelli RA, et al. Perfusion CT in acute stroke: effectiveness of automatically-generated colour maps[J]. Br J Radiol, 2017, 90: 20150472.
[34] Li Y, Niu K, Li K, et al. C-arm cone beam CT perfusion imaging using the SMART-RECON algorithm to improve temporal sampling density and temporal resolution[J]. Proc SPIE Int Soc Opt Eng,2016,9783:97830U.
[35] Garrett JW, Li Y, Li K, et al. Quantification of temporal resolution improvement factor in SMART-RECON based time-resolved C-arm cone beam computed tomography angiography (TR-CBCTA)[J]. Phys Med Biol, 2018: 63 :19NT02..
[36] Li Y, Garrett JW, Li K, et al. An enhanced SMART-RECON algorithm for time-resolved C-arm cone-beam CT imaging[J]. IEEE Trans Med Imaging, 2020, 39: 1894-1905.
[37] Moriya M, Itokawa H, Fujimoto M, et al. Evaluation of patients with acute ischemic stroke using angiographic C-arm cerebral blood volume (C-arm CBV) measurements[J]. J Endovasc Ther, 2018, 12:57-62.

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备注/Memo

备注/Memo:
(收稿日期:2021-12-29)
(本文编辑:边 佶)
更新日期/Last Update: 2023-03-03