摘要
目的评价64层CT脑灌注成像在颈内动脉狭窄支架植入前后的应用价值。方法回顾性分析2007年7月至2010年2月行颈内动脉支架植入术的40例脑缺血患者,所有患者均为单侧颈内动脉重度狭窄(狭窄程度大于75%),分别在支架植入1 d前及植入5 d后行64层CT灌注成像,取半卵圆中心层面白质区前、中、后3点测量双侧颈内动脉供血区对应部位白质的脑血流量(CBF)、脑血流容积(CBV)及平均通过时间(MTT),并计算患侧和对侧相对值rCBF、rCBV及r MTT,比较术前双侧血流灌注的差异及术后缺血区域的灌注恢复情况。结果支架植入前颈内动脉狭窄侧和对侧的CBF、CBV、MTT分别为(14.86±4.54)mL.(100 g)-1.min-1、(1.08±0.32)mL/100 g、(6.54±1.96)s和(21.06±6.83)mL.100 g-1.min-1、(1.06±0.20)mL/100 g、(4.21±2.10)s,颈内动脉狭窄侧较对侧CBF明显下降,MTT明显延长(P<0.05);支架植入前后rCBF、rCBV及r MTT分别为0.76±0.31、1.04±0.34、1.82±0.64和0.94±0.38、1.07±0.28、1.29±0.57,支架植入后对应供血区脑组织血流灌注明显改善(P<0.05)。结论脑灌注成像能敏感的检测颈内动脉狭窄患者脑内血流动力学改变,是评价颈内动脉支架植入治疗缺血性脑卒中疗效的可靠方法。
Objective To evaluate the value of 64-slice CT perfusion imaging in internal carotid artery（ICA） stenosis before and after stent placement.Methods 40 patients with the ICA stent placement were retrospective analysised,and all patients were unilateral ICA severe stenosis（the degree of stenosis greater than 75%）.Perfusion CT（PCT） was done a day before and five days after the stent implanted respectively,the cerebral blood flow（CBF）,cerebral blood volume（CBV） and mean transit time（MTT） were measured at the white matter aeras of ICA stenosis and their correspond parts on contralateral side,and the relative values of rCBF,rCBV,and rMTT were calculated at the bilateral cerebral.Results Pre-stent,the CBF,CBV,MTT were（14.86±4.54）mL·100 g-1·min-1,（1.08±0.32）mL/100 g,（6.54±1.96）s and（21.06±6.83））mL/100 g,（1.06±0.20）mL·（100） g-1·min-1,（4.21±2.10）s at lesion side and contralateral respectively,and the differences of CBF and MTT on the leision side and contralateral were significant（P 0.05）.The rCBF,rCBV and rMTT were respectively 0.76±0.31,1.04±0.34,1.82±0.64 and 0.94±0.38,1.07±0.28,1.29±0.57 before and after stenting,and the blood perfusion improved significantly after stenting（P0.05）.Conclusion PCT can detect the cerebral hemodynamic changes sensitively,it is a reliable mean to evaluate treatment effectiveness of ICA stenting in patients with ischemic stroke.
出处
《重庆医学》
CAS
CSCD
北大核心
2011年第2期111-112,114,F0002,共4页
Chongqing medicine
关键词
颈内动脉狭窄
卒中
支架
CT灌注成像
internal carotid artery stenosis
stroke
stents
CT perfusion imaging
