摘要
目的应用CT灌注(computed tomography perfusion,CTP)成像技术探讨幕上各分水岭区血流灌注与颈内动脉(internal carotid artery,ICA)狭窄程度的相关性。方法分析97例单侧ICA狭窄(≥50%)患者的临床及CTP资料,并以37例无血管狭窄(或单侧ICA狭窄<50%)患者为对照组。所有患者在入院后均行CT平扫、CTP及数字减影血管造影(digital subtraction angiography,DSA)检查,对称性选取双侧幕上各分水岭区,进行参数值的测量。分析不同狭窄程度组各分水岭区的灌注状态。结果单侧ICA狭窄时,各个分水岭区患侧与健侧的平均通过时间(mean transit time,MTT)和达峰时间(time to peak,TTP)差异有统计学意义(P<0.05),患侧较健侧时间延长;仅在半卵圆中心患侧脑血流量(cerebral blood flow,CBF)较健侧明显降低,差异有统计学意义(P<0.05);后角白质患侧脑血容量(cerebral blood volume,CBV)较健侧增加,差异有统计学意义(P<0.05);前角和后角的灰质CBF、CBV均高于同侧白质,差异有统计学意义(P<0.05)。半卵圆中心rCBF、rTTP、rMTT在不同狭窄组间差异有统计学意义(P<0.05),放射冠rTTP、rMTT在不同狭窄组间差异有统计学意义(P<0.05),前角白质rTTP在不同狭窄组间差异有统计学意义(P<0.05)。结论CTP成像能够有效评价幕上分水岭区脑血流灌注情况。单侧ICA狭窄时,不同分水岭区脑血流灌注存在差异;单侧ICA重度狭窄或闭塞时,仅半卵圆中心表现为低灌注。
Objective The correlation between blood perfusion in the supratentorial watersheds and the degree of stenosis of the internal carotid artery(ICA)was investigated by computed tomography perfusion(CTP)imaging technology.Methods 97 patients with unilateral ICA stenosis(≥50%)were analyzed,and 37 patients without vascular stenosis(or unilateral ICA stenosis<50%)were used as the control group.All patients under⁃went CT scan,CTP and digital subtraction angiography(DSA)examination after admission.The watershed areas of the bilateral supratentorial areas were selected symmetrically to measure the parameter values.The perfusion status of each watershed area in different stenosis degree groups was statistically analyzed.Result In the case of unilateral ICA stenosis,the difference in mean transit time(MTT)and time to peak(TTP)between the affected side and the healthy side in each watershed area was statistically significant(P<0.05),and the affected side was more healthy than the healthy side.Only the cerebral blood flow(CBF)on the affected side of the semiovale cen⁃ter was significantly lower than that on the healthy side,and the difference was statistically significant(P<0.05).,CBV)was increased compared with the healthy side,and the difference was statistically significant(P<0.05).The rCBF,rTTP and rMTT in the center of semiovale were statistically significant between different steno⁃sis groups(P<0.05),the corona radiata rTTP and rMTT were statistically significant between different stenosis groups(P<0.05),and the anterior horn white matter rTTP in different stenosis groups There was statistical signifi⁃cance(P<0.05).Conclusion CTP imaging can effectively evaluate the cerebral blood perfusion in the supratentorial watershed area.In unilateral ICA stenosis,there were differences in cerebral blood perfusion in different watershed areas;in severe unilateral ICA stenosis or occlusion,only the center of semiovale showed hypoperfusion.
作者
裴禹淞
乔鑫鑫
王治国
张国旭
PEI Yusong;QIAO Xinxin;WANG Zhiguo;ZHANG Guoxu(General Hospital of Northern Theater Command,Shenyang 110016,China)
出处
《中国实用神经疾病杂志》
2022年第6期705-712,共8页
Chinese Journal of Practical Nervous Diseases
基金
辽宁省重点研发资助计划(编号:2019JH2/10300010)。
关键词
颈内动脉
狭窄
分水岭
CT灌注
Internal carotid artery
Stenosis
CT perfusion imaging
watershed
