摘要
目的探讨分水岭脑梗死患者的脑血流动力学改变与颅内外血管狭窄的相关性。方法选取我院分水岭脑梗死的患者46例,所有患者均行脑CT灌注联合头颈部CT血管成像检查。扫描结束后,采用CT灌注和血管相关软件技术评价脑血流动力学的改变和颅内外血管的狭窄程度及两者之间的关系。结果34例患者行CT脑灌注检查时在分水岭梗死区域外出现异常灌注。患侧前循环大脑中动脉供血分布区与对侧相比较,其平扫通过时间(MTT)、峰值时间(TTP)和脑血流量(CBF)的差异有统计学意义(P<0.01),而两侧的脑血容量(CBV)的差异无统计学意义(P>0.05)。后循环供血分布区表现TTP及MTT延迟,而CBV、CBF无变化。根据平扫通过时间和峰值时间图,将灌注延迟范围分3型:1型分水岭梗死区域外无异常灌注12例;Ⅱ型为分水岭梗死区域外仅前循环或后循环供血分布区出现异常灌注25例;Ⅲ型为分水岭区域外同时出现前后循环供血分布区异常灌注9例。脑灌注异常的分布与颅内外相应供血动脉的狭窄程度显示呈正相关(Spearman相关系数为0.75,P<0.01)。结论分水岭脑梗死与头颈部颅内外供应血管的狭窄及程度密切相关,分水岭脑梗死最重要的诱发因素是在颅内外供血大动脉严重狭窄甚至闭塞的基础上发生低灌注血流或无血流灌注。
Objective To investigate the correlation between cerebral hemodynamic changes and intracranial and extracranial vascular stenosis in patients with watershed cerebral infarction.Methods A total of 46 patients with watershed cerebral infarction in our hospital were enrolled.All patients underwent cerebral CT perfusion combined with CT angiography of the head and neck.After the scan,CT perfusion and blood vessel related software technology were used to evaluate the cerebral hemodynamic changes and the degree of stenosis of intracranial and extracranial blood vessels and the relationship between the two.Results 34 patients had abnormal perfusion outside the watershed cerebral infarction area during cerebral perfusion CT examination.Compared with the contralateral side,the blood supply distribution area of the middle cerebral artery in the anterior circulation of the affected side had statistically significant differences in mean transit time(MTT),time to peak(TTP)and cerebral blood flow(CBF)(P<0.01),while the difference in cerebral blood volume(CBV)on both sides was not statistically significant(P>0.05).The blood supply distribution area of the posterior circulation showed delayed TTP and MTT,but there was no change in CBV and CBF.According to the MTT and TTP chart,the perfusion delay range was divided into 3 types:Type 1:12 cases without abnormal perfusion outside the watershed cerebral infarction area;Type Ⅱ:25 cases with abnormal perfusion in the blood supply distribution area of the anterior or posterior circulation outside the watershed cerebral infarction area;Type Ⅲ:9 cases with abnormal perfusion in the blood supply distribution area of the anterior and posterior circulation outside the watershed cerebral infarction area.The distribution of abnormal cerebral perfusion was positively correlated with the degree of stenosis of the intracranial and extracranial corresponding blood supply arteries(Spearman correlation coefficient was 0.75,P<0.01).Conclusion Watershed cerebral infarction was closely related to
作者
傅俊明
欧鸿儒
张冠业
莫家彬
简坚成
FU Jun-ming;OU Hong-ru;ZHANG Guan-ye;MO Jia-bin;JIAN Jian-cheng(Department of Imaging,Shunde Hospital Affiliated to Jinan University(the Second People's Hospital of Shunde District,Foshan City,Feng Yaojing Memorial Hospital,Shunde District,Foshan City),Shunde 528305,Guangdong Province,China)
出处
《罕少疾病杂志》
2022年第5期21-24,共4页
Journal of Rare and Uncommon Diseases
