摘要
目的对外科和介入治疗前后ICA/MCA慢性重度狭窄或闭塞患者的脑灌注成像进行比较分析,探讨其对疗效评价的应用。方法23例单侧慢性ICA/MCA重度狭窄或闭塞患者,分别于外科或介入治疗前后行MR脑灌注成像检查,计算脑灌注参数图,包括rCBF、rCBV、rMTT和TTP,对治疗前后脑灌注参数进行定性和定量比较分析。23例患者中10例行STAMCA吻合术,10例行PTAS,3例行CEA。10例行STAMCA吻合术中6例为MCA闭塞,4例为ICA闭塞;10例行PTAS中7例为ICA重度狭窄,3例MCA重度狭窄;3例行CEA均为ICA重度狭窄。结果23例慢性ICA/MCA重度狭窄或闭塞患者,治疗前TTP、rMTT图均发现病变侧灌注延迟,而rCBF、rCBV图改变不明显,治疗后TTP、rMTT图上灌注异常区较治疗前减小,有显著性差异(P<0.01),rCBF和rCBV图与术前比较均无明显变化。治疗后病变区TTP、rMTT值较治疗前减低,有显著性差异(P<0.01),rCBF和rCBV值无显著性差异(P>0.05)。结论PWI检查能够观察外科和介入治疗前后脑灌注的改善情况,为评价疗效提供影像学依据。
Objective To assess the utility of perfusion-weighted imaging （PWI） for evaluating cerebral hemodynamic changes before and after surgery or interventional therapy in patients with unilateral ICA/MCA high-grade stenosis or occlusion. Methods PWI was performed on 23 patients with unilateral ICA/MCA high-grade stenosis or occlusion. The cerebral perfusion parameters such as rCBF, rCBV, rMTT and TTP were calculated. 10 patients underwent STA-MCA anastomosis, 10 patients underwent PTAS and 3 patients underwent CEA. Results The abnormal perfusion findings were depicted in 23 patients with ICA/MCA high-grade stenosis or occlusion. The values of TTP and rMTT were decreased after therapy, and the difference was statistically significant （P〈0. 01）. However, there was no statistically significant difference between the values of rCBF and rCBV before and after therapy （P〉0. 05）. The extents of abnormal perfusion were decreased on TTP and rMTT maps after therapy, and the differences were statistically significant （P〈0. 01）. Conclusion PWI examina- tion can depict the improved situation of cerebral perfusion after surgery or interventional therapy, and provided the basis of imaging for evaluating curative effect.
出处
《中国医学影像技术》
CSCD
北大核心
2006年第6期841-844,共4页
Chinese Journal of Medical Imaging Technology
基金
北京市优秀人才培养资助项目资助(20042D0501809)
关键词
颈内动脉
大脑中动脉
狭窄
闭塞
磁共振成像
灌注
Internal carotid artery
Middle cerebral artery
Stenosis, occlusion
Magnetic resonance imaging
Perfusion
