论文部分内容阅读
目的探讨单侧颈动脉狭窄所致慢性脑缺血(CCI)的CT灌注成像(CTP)特点及与颈动脉狭窄程度的相关性。方法回顾性分析临床诊断慢性脑供血不足且经头颈CTA证实仅单侧颈动脉狭窄36例患者的CTP表现,分别测量额叶、基底节区、颞叶健侧和患侧的相对血容量(r CBV)、相对血流量(r CBF)、平均通过时间(MTT)及达峰时间(TTP),统计分析各参数患侧及健侧的统计学差异;按颈动脉狭窄程度进行分组,并统计分析组内各参数的统计学差异,分析CCI与颈动脉狭窄程度的相关性。结果 36例中左侧颈动脉狭窄17例,右侧颈动脉狭窄19例;轻度狭窄11例,中度狭窄17例,重度狭窄8例;轻、中度狭窄组各灌注参数均无统计学意义(P>0.05),重度狭窄组r CBV、r CBF、MTT、TTP均有明显统计学差异(P<0.05)。结论 CTP能反映单侧颈动脉狭窄所致CCI的血流动力学变化,为临床诊断及治疗提供依据。CCI患者脑组织血流动力学变化与颈动脉狭窄程度具有一定的相关性。
Objective To investigate the CT perfusion imaging (CTP) characteristics of chronic cerebral ischemia (CCI) caused by unilateral carotid artery stenosis and its correlation with the degree of carotid artery stenosis. Methods The CTP findings of 36 patients with unilateral carotid artery stenosis confirmed by head-neck CTA were retrospectively analyzed. The relative volume of frontal lobe, basal ganglia, contralateral side of temporal lobe and affected side were measured (r CBV), relative CBF (r CBF), mean transit time (MTT) and time to peak (TTP) were calculated. The statistical differences between affected side and contralateral side of each parameter were statistically analyzed. According to the degree of carotid artery stenosis, The statistical differences among the parameters in the group were analyzed, and the correlation between CCI and carotid artery stenosis was analyzed. Results In the 36 cases, there were 17 cases of carotid stenosis on the left side and 19 cases of stenosis on the right side. There were 11 cases of mild stenosis, 17 cases of moderate stenosis and 8 cases of severe stenosis. There was no statistical difference in perfusion parameters between mild and moderate stenosis group (P> 0.05). The levels of r CBV, r CBF, MTT and TTP in severe stenosis group were significantly different (P <0.05). Conclusion CTP can reflect the hemodynamic changes of CCI caused by unilateral carotid stenosis and provide the basis for clinical diagnosis and treatment. CCI patients with hemodynamic changes in brain tissue and carotid stenosis have a certain degree of correlation.