摘要
目的 观察颅内外动脉狭窄患者术前脑CT灌注成像(CTP)特点,并分析其对支架成形术后发生脑过度灌注综合征(CHS)的预测价值。方法 回顾性分析2017年1月至2019年2月我院收治的颅内或颅外动脉狭窄患者136例,患者均行单侧血管支架成形术,术前1周进行脑CTP检查,获取脑CTP的相关参数。结果 90例灌注异常患者狭窄侧CBF低于正常侧(P<0.05),MTT、TTP均长于正常侧(P<0.05),两侧CBV无明显差异(P>0.05);与术前比较,136例患者支架成形术后rCBF增大(P<0.05),rMTT、rTTP均减小(P<0.05),rCBV无明显差异(P>0.05);136例患者支架成形术后发生CHS 7例(5.15%),CHS患者与非CHS患者rCBF、rCBV比较,差异无统计学意义(P>0.05),CHS患者rMTT、rTTP均大于非CHS患者(P<0.05);术前rMTT、rTTP预测患者术后发生CHS的AUC分为为0.730、0.821。结论 脑CTP能准确反映颅内外狭窄患者支架成形术前后的血流动力学变化,术前rMTT、rTTP对CHS的发生可能具有一定预测价值。
Objective To observe the features of preoperative brain CT perfusion imaging(CTP) in patients with intracranial and extracranial artery stenosis, and to analyze their predictive value on cerebral hyperperfusion syndrome(CHS) after stenting. Methods A retrospective analysis was performed on 136 patients with intracranial or extracranial artery stenosis admitted to our hospital from January 2017 to February 2019. All patients underwent unilateral vascular stenting and were given brain CTP at 1 week before surgery. The related parameters of brain CTP were obtained. Results The CBF of stenosis side of 90 patients with perfusion abnormalities was lower than that of normal side(P<0.05), and the MTT and TT P were longer than those of normal side(P<0.05), and there was no significant difference in the CBV between the two sides(P>0.05). Compared with before surgery, the rCBF was increased after stenting in 136 patients(P<0.05) while the rMTT and rTT P were decreased(P<0.05), and there was no significant difference in the rCBV(P>0.05). There were 7 cases(5.15%) of CHS among 136 patients after stenting, and there were no significant differences in the rCBF and rCBV between CHS patients and non-CHS patients(P>0.05), and the rMTT and rTT P of CHS patients were greater than those of non-CHS patients(P<0.05). The AUC values of preoperative rMTT and rTT P in predicting CHS after surgery were 0.730 and 0.821. Conclusion Brain CTP can accurately reflect the hemodynamic changes before and after stenting in patients with intracranial and extracranial artery stenosis.Preoperative rMTT and rTT P may have predictive value on the occurrence of CHS.
作者
曾庆
曾宪强
李义
张晓亚
温昌明
ZENG Qing;ZENG Xian-qiang;LI Yi;ZHANG Xiao-ya;WEN Chang-ming(Department of Radiology,Nanyang Central Hospital,Nanyang 473000,Henan Province,China)
出处
《中国CT和MRI杂志》
2022年第5期46-48,共3页
Chinese Journal of CT and MRI
关键词
CT灌注成像
颅内外动脉狭窄
支架成形术
脑过度灌注综合征
CT Perfusion Imaging
Intracranial and Extracranial Artery Stenosis
Stenting
Cerebral Hyperperfusion Syndrome
