摘要
目的 探究CT灌注成像在出血型烟雾病患者手术效果分析中的应用.方法 回顾性分析158例出血型烟雾病患者的临床资料,所有患者均顺利完成血管重建术治疗.比较出血侧与对侧血肿区周围、颞叶、额叶的脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)和达峰时间(TTP),并比较术前、术后即刻、术后1周与术后3个月时相对脑血流量(rCBF)、相对脑血容量(rCBV)、相对平均通过时间(rMTT)和相对达峰时间(rTTP)的差异.结果 出血侧血肿区周围CBF低于对侧,MTT和TTP高于对侧,出血侧颞叶CBF低于对侧,TTP高于对侧,差异均统计学意义(t分别=2.19、2.52、2.56、2.29、2.56,P均<0.05).颞叶部位术后rCBF、rTTP高于术前,rMTT低于术前,额叶部位术后rCBF、rTTP高于术前,差异均有统计学意义(t分别=2.19、2.49、2.56、3.10、2.50,P均<0.05).颞叶部位和额叶部位术后3个月的rCBV、rMTT低于术后1周,rTTP高于术后1周,差异均有统计学意义(t分别=2.13、2.92、1.98、1.60、2.86、2.52、2.56,P均<0.05).结论 出血型烟雾病患者存在脑灌注严重不足,以颞叶和额叶最为明显;rCBV、rMTT、rTTP的时间参数对区分缺血程度具有较高的敏感性,能够显示早期细微的缺血变化,评价血管重建术后脑血流动力学的改善情况.
Objective To explore the application of CT perfusion imaging in the analysis of surgical effect of hemor⁃rhagic moyamoya disease.Methods The clinical data of 158 patients with hemorrhagic moyamoya disease were retro⁃spectively analyzed.The cerebral blood flow(CBF),cerebral blood volume(CBV),mean passage time(MTT),and peak arrival time(TTP)were compared between the hemorrhagic and contralateral hematoma areas,temporal lobe and frontal lobe.The differences in relative cerebral blood flow(rCBF),relative cerebral blood volume(rCBV),relative mean passage time(rMTT)and relative peak arrival time(rTTP)before surgery,after surgery at the immediately,1 week and 3 months after surgery were compared.Results The CBF around hematoma area in the hemorrhagic side was lower than that in the contralateral side,MTT and TTP were higher than those in the contralateral side,CBF in the hemorrhagic side of the temporal lobe was lower than that in the contralateral side,and TTP was higher than that in the contralateral side,the dif⁃ferences were statistically significant(t=2.19,2.52,2.56,2.29,2.56,P<0.05).The rCBF and rTTP after temporal lobe su⁃rgery were higher than before surgery,rMTT was lower than before surgery,and rCBF and rTTP after frontal lobe surgery were higher than before surgery,the differences were statistically significant(t=2.19,2.49,2.56,3.10,2.50,P<0.05).The rCBV and rMTT in temporal lobe and frontal lobe were lower than those at 1 week after surgery,and rTTP was high⁃er than that at 1 week after surgery,with statistically significant differences(t=2.13,2.92,1.98,1.60,2.86,2.52,2.56,P<0.05).Conclusion Patients with hemorrhagic moyamoya disease have severe cerebral perfusion insufficiency,which is most obvious in the temporal lobe and frontal lobe.The time parameters of rCBV,rMTT and rTTP are highly sensitive to distinguish the degree of ischemia,and can show the subtle changes of early ischemia,which is helpful for evaluating the changes of cerebral hemodynamics after revascularization.
作者
戚洲卿
QI Zhouqin(Department of Radiology,Zhuji People’s Hospital,Shaoxing 311800,China)
出处
《全科医学临床与教育》
2020年第5期427-430,共4页
Clinical Education of General Practice
关键词
出血型烟雾病
CT灌注成像
血流动力学
颞叶
额叶
hemorrhagic moyamoya disease
CT perfusion imaging
hemodynamics
the temporal lobe
the frontal lobe
