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目的：探索64排 CT 脑灌注成像辅以 CT 血管造影应用于颈内动脉系统的短暂性脑缺血（TIA）和急性脑梗死（ACI）的影像诊断价值。方法在2014年8月至2015年8月期间选取100例颈内系统 TIA 患者和100例颈内系统 ACI 患者为研究对象，对所有患者进行64排 CT 脑灌注成像辅以 CTA检查。64排 CT 脑灌注成像检测并对比两组患侧脑内感兴趣区与健侧镜像对照区的对比剂平均通过时间(MTT)、脑血流量(CBF)和脑血容量(CBV)，同时， CTA 检测颈内动脉管腔狭窄情况。结果两组的患侧较健侧 MTT 延迟、CBF 与 CBV 下降，但 TIA 组 CBV 轻度下降。同时 TIA 组患者颈内动脉无和轻度狭窄合计比率（66.13%）高于 ACI 组患者，中重度狭窄合计比率（33.87%）低于 ACI 组患者（P＜0.05）。结论64排 CT 脑灌注成像辅以 CT 血管造影应用于诊断颈内动脉系统的 TIA 和 ACI 效果显著，可较好的显示血管腔内情况，提示脑部缺血程度。“,”Objective To explore the diagnostic value of 64 slice CT perfusion imaging with CT angiography in the diagnosis of TIA and ACI in the internal carotid artery system.Methods From August 2014 to August 2015,100 patients with internal carotid system TIA and ACI patients with were selected as subjects. Al the patients underwent 64 slice CT perfusion imaging and CTA. The MTT,CBF and CBV of the two groups of patients with brain lesions and the control area of the healthy side were compared and analyzed. And CTA in detecting internal carotid artery stenosis. Results MTT,CBF and CBV were decreased in the two sides of the affected side than the healthy side,but the CBV in the TIA group decreased slightly.TIA group of patients without stenosis and mild stenosis ratio (66.13%) was higher than that in group ACI.And the proportion of moderate and severe stenosis in TIA group (33.87%) was lower than that in group ACI (P <0.05).Conclusion 64 row CT cerebral perfusion imaging combined with CTA in the diagnosis of internal carotid artery system TIA and ACI effect is remarkable, can better show the lumen of the situation,indicating the degree of cerebral ischemia.