论文部分内容阅读
目的利用CT灌注(CTP)探讨不同程度慢性单侧大脑中动脉(MCA)狭窄患者脑血流动力学改变,并联合CT血管成像(CTA)评价MCA狭窄程度及颅内血管情况与脑血流灌注参数的关系。资料与方法 89例MCA狭窄患者根据其狭窄程度分为3组。分别计算各组中MCA供血区CTP的均值和狭窄侧/对侧比值,评价各组的脑血流动力学改变。利用CTA联合DSA评估MCA狭窄程度及颅内血管情况与灌注参数的相关性。结果 (1)大部分患者长期处于“良性灌注不良”状态,脑血流量(CBF)维持稳定,脑血容量(CBV)升高,最大峰值时间(TTP)延长。(2)TTP比值(rTTP)与MCA狭窄程度具有较强的等级相关性(r=0.713,P<0.01),CBV比值(rCBV)与狭窄程度有弱相关性(r=0.365,P<0.01)。(3)对于Willis环发育异常或狭窄患者,其rTTP明显延长,提示脑血流动力学损害严重。结论 CTP联合CTA能够全面了解MCA狭窄脑血流动力学损伤情况。
Objective To evaluate the changes of cerebral hemodynamics in patients with different degrees of chronic unilateral middle cerebral artery (MCA) stenosis by CT perfusion (CTP), and to evaluate the degree of stenosis and intracranial blood vessels and cerebral perfusion in patients with MCA by CT angiography (CTA) The relationship between the parameters. Materials and Methods 89 patients with MCA stenosis were divided into 3 groups according to the degree of stenosis. The mean CTP and stenosis / contralateral ratio of MCA donor area in each group were calculated and the cerebral hemodynamic changes were evaluated. CTA combined with DSA assessment of MCA stenosis and intracranial vascular conditions and perfusion parameters correlation. Results (1) Most of the patients were in the condition of “benign perfusion” for a long time. The blood flow (CBF) remained stable, the cerebral blood volume (CBV) increased and the maximum peak time (TTP) prolonged. (2) There was a strong rank correlation between TTP ratio (rTTP) and stenosis of MCA (r = 0.713, P <0.01) and weak correlation between rCBV and stenosis (r = 0.365, . (3) For patients with abnormal Willis ring development or stenosis, its rTTP was significantly prolonged, suggesting severe hemodynamic damage. Conclusion CTP combined with CTA can fully understand the MCA stenosis cerebral hemodynamic damage.