Computed tomography perfusion in acute ischemic stroke

Uvod: Akutna možganska kap je stanje s katerim se srečujemo vsakodnevno tako zdravstveni delavci, kot tudi drugi. Ker gre za stanje, pri katerem se zmanjša dotok krvi v možganske celice, se mora v takih primerih čim hitreje ukrepati, saj so lahko nevrološke posledice za človeka nepopravljive. Najpogosteje se zato uporablja hitro diagnostično metodo, računalniško tomografijo. Namen: V projektni nalogi smo želeli predstaviti slikovno-preiskovalno metodo, ki nam pomaga oceniti jakost, razsežnost in škodo, ki se pojavi ob ishemični kapi. Govorili bomo o računalniško tomografski perfuziji, predstavili njene parametre ter poskušali grafično prikazati kakšne so razlike pri posameznih pacientih na ishemičnem in neishemičnem tkivu. Metode: Meritve smo opravili na Nevrološki kliniki v Ljubljani, podatke smo zbrali retrospektivno. Izvedene meritve smo razdelili na dva dela. Celoten vzorec je zajemal 20 pacientov z napotno diagnozo sum na ishemično kap. Pri prvih desetih pacientih smo določili okvirne vrednosti perfuzijskih parametrov. Ker smo ugotovili, da se vrednosti razlikujejo od posameznika do posameznika, smo v drugem delu primerjali vrednosti za posameznega pacienta v zdravem in nezdravem tkivu. Rezultati: Vrednosti CBF v prvem delu meritev se gibljejo med 21,03 in 34,15 ml/s. CBV pa se giblje med 1,4 in 2,1 ml/100g tkiva. Od vseh parametrov je imel najvišji razpon TTP, med posamezniki variira zaradi različnega pretoka krvi. V drugem delu meritev smo grafično prikazali razlike v parametrih za vsakega pacienta posebej, kjer so bile vidne razlike v ishemičnem in neishemičnem tkivu. Ocenili smo lahko tudi ali je bila kap blaga ali huda. Razprava in zaključek: Prišli smo do ugotovitev, da vsi perfuzijski parametri zelo variirajo med posamezniki. Na to vpliva starost, srčna funkcija in fiziološko stanje, kar je pomenilo, da rezultatov nismo mogli posplošiti na celotno populacijo. Zato smo v drugem delu meritev, pri vsakem pacientu posebej primerjali perfuzijske parametri v ishemičnem in neishemičnem tkivu.Introduction: Stroke is a condition with whom medical personnel, as other people, get encountered with every day. Because it is a condition where the blood stream to the brain cell is reduced, it is needed to take measures as soon as possible, due to irreversible neurological consequences. The diagnostic method that is in use most often is computed tomography. Purpose: We wanted to show imaging method that helps us evaluate the intensity, range and damage that occur in brain stroke. It will be spoken about computed tomography perfusion, introduce its parameters and graphically show the differences between individual patient in ischemic and non-ischemic tissue. Methods: Measurements were done at Neurologic clinic in Ljubljana, data was gathered retrospective. Measurements were divided into two parts. Whole pattern included 20 patients with clinical suspicion of an ischemic stroke . In first ten patients we wanted to define approximate value od perfusion parameters. Due to our findings, that the values distinguish between every individual, we compared the values for every individual separately in the second part of the measurements. Results: The values of CBF from the first part of the measurements were hovering between 21,03 and 34,15 ml/s. The range of CBV was between 1,4 and 2,1 ml/100g of tissue. The biggest range had TTP due to diferences in blood flow for every individual. In the second part of the measurements, it was graphically shown, the parameters for each individual, were we could see the differences in ischemic and non-ischemic tissue. We could also evaluate if the stroke was mild or severe. Discussion and conclusion: Our findings showed that all perfusion parameters variety between every individual. They are affected by age, heart function and physiologic state, that meant that we could not generalize the results for all the population. This is why our second part of the research we compared the ischemic and non-ischemic tissue for every individual separately