摘要
目的利用CT灌注(CTP)联合CT血管成像(CTA)分析单侧大脑中动脉(MCA)狭窄或闭塞患者的脑血管自身调节储备能力及侧支循环建立情况。方法对30例单侧MCA狭窄或闭塞患者行CTP及CTA检查,以20名志愿者作为对照组,将对照组各参数右/左侧相对比值的95%可信区间为参考值,分析病变组各灌注参数患/健侧相对比值的特点,并利用CTA观察不同临床表现患者的侧支循环代偿情况。结果除1例MCA狭窄患者灌注正常外,29例异常灌注分为三型:Ⅰ型,CBF与CBV正常,TTP延长(3例);Ⅱ型,CBF和CBV升高,TTP延长(16例);CBF和CBV降低,TTP延长(4例);Ⅲ型,CBF降低,CBV升高,TTP延长(6例)。大面积脑梗死患者(5例)侧支循环代偿欠佳,部分合并颈动脉及椎-基底动脉狭窄;25例临床正常或表现为腔隙性梗死患者侧支循环良好。结论CTP联合CTA可很好地评估单侧MCA狭窄或闭塞患者的脑血供和脑血流动力学,其临床转归与脑血管自身调节储备及侧支循环建立这两种脑血流代偿机制密切相关。
Objective To evaluate cerebral hemodynamics changes and collateral circulation in patients with unilateral middle cerebral artery（MCA）stenosis or occlusion with CT perfusion（CTP）and CT angiography（CTA）.Methods CTP and CTA were performed in 30 patients with unilateral MCA stenosis or occlusion.Twenty normal persons were regarded as the control group.Hemodynamic parameters were calculated and compared between the ratio of stenosed or occluded/contralateral side and the ratio of left/right side.The conditions of collateral blood supply for patients with different clinical manifestation were investigated.Results In 30 patients,29 had cerebral infarction,while only one with MCA stenosis was normal in CTP.Three types of CTP were found,including Ⅰ：cerebral blood flow（CBF）and cerebral blood volume were normal（CBV）,time to peak（TTP）was delayed（n=3）;Ⅱ：CBF and CBV increased,TTP were delayed（n=16）;CBF and CBV decreased,TTP were delayed（n=4）;Ⅲ：CBF decreased,CBV increased,TTP were delayed（n=6）.In 5 patients suffered from cerebral infarction,other carotid or vertebral artery stenosis and the deficiency of collateral blood supply were noticed,whereas good collateral blood supply was found in 25 patients with slight clinical symptoms.Conclusion CTP combined CTA can precisely evaluate the hemodynamics and collateral blood supply in patients with unilateral MCA stenosis or occlusion.The clinic turnover of patients with MCA stenosis or occlusion is well correlated to the hemodynamics and collateral blood supply.
出处
《中国医学影像技术》
CSCD
北大核心
2009年第11期1988-1991,共4页
Chinese Journal of Medical Imaging Technology
