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目的:研究颈动脉支架置入术对腔隙性脑梗死患者脑灌注的影响。方法:选取本院近3年收治的接受颈动脉支架置入术的腔隙性脑梗死患者56例,分为有症状组39例,无症状组17例。在接受颈动脉支架置入术前后对患者进行计算机断层扫描灌注(CTP)检查,然后计算平均通过时间(MTT),脑血流量(CBF)以及脑血容量(CBV),并且计算出患侧与健侧的脑血流量和脑容量的比值(rCBF和rCBV),以及平均通过时间的差值(dMTT)。结果:在治疗后,两组患者的脑灌注各项指标均有所改善,在治疗前,有症状组的患者脑血流量受损更明显。结论:颈动脉支架置入术对有症状和无症状的腔隙性脑梗死患者的患侧脑血流量均有改善。CTP参数分析可以用来帮助识别有无症状腔隙性脑梗死患者在血管重建前的差异性,以及它们的治疗反应的差异性。
Objective: To study the effect of carotid artery stenting on cerebral perfusion in patients with lacunar infarction. Methods: Fifty-six patients with lacunar infarction receiving carotid stenting admitted to our hospital in the recent 3 years were divided into symptomatic group (n = 39) and asymptomatic group (n = 17). Patients underwent computed tomography perfusion (CTP) examinations before and after carotid stenting, and mean transit time (MTT), cerebral blood flow (CBF) and cerebral blood volume (CBV) were calculated and the affected side And contralateral cerebral blood flow and brain volume ratio (rCBF and rCBV), and the difference in mean transit time (dMTT). Results: After treatment, the indexes of cerebral perfusion in both groups were improved, and the cerebral blood flow in patients with symptomatic group was more damaged before treatment. CONCLUSIONS: Carotid artery stenting improves ipsilateral cerebral blood flow in patients with both symptomatic and asymptomatic lacunar infarctions. CTP parameter analysis can be used to help identify differences in patients with asymptomatic lacunar infarcts before revascularization and their treatment response.