摘要
目的:探究头颅CT血管成像(computed tomography angiography,CTA)评估缺血性卒中患者侧支循环情况及脑灌注状态的价值。方法:回顾性分析靖江市人民医院2021年2月—2023年2月接诊的缺血性卒中患者128例进行研究,患者均进行头颅CT血管成像检查,分析所有患者灌注参数、侧支循环情况以及头颅CT血管成像的评估价值。结果:头颅CT血管成像检查结果:①27例患者的平扫无异常,101例患者有明显病灶。实施头颈部多时相CTA,128例患者一侧脑血管狭窄甚至闭塞;57例患者侧支循环建立不良,其余患者侧支循环建立均良好。所有患者中评分为1分的患者19例,2分患者38例,3分患者45例,4分患者26例。②侧支循环良好组患者病灶侧脑血流量(CBF)低于健侧,平均通过时间(MTT)、峰值时间(TTP)长于健侧,差异显著(P<0.01),病灶侧及健侧脑血容量(CBV)比较差异无统计学意义(P>0.05);侧支循环不良组病灶侧CBV、CBF低于健侧,MTT及TTP长于健侧,差异显著(P<0.05)。③侧支循环不良组rCBV、rCBF显著低于侧支循环良好组,rTTP显著高于侧支循环良好组,梗死灶面积显著大于侧支循环良好组(P<0.01)。结论:头颅CT血管成像可观察颅内血管病变及侧支循环形成情况,医生根据头颅CT成像可知患者脑血管狭窄以及闭塞情况,并分析患者的测试侧支循环情况以及与脑血流灌注情况之间的关系,在临床上能够为脑血管疾病的诊疗评估提供科学依据。
Objective To explore the value of head CT angiography(CTA)in evaluating collateral circulation and cerebral perfusion status in patients with ischemic stroke.Methods A retrospective analysis was conducted on 128 patients with ischemic stroke who were admitted to Jingjiang People's Hospital from February 2021 to February 2023.All patients underwent head CT angiography.Perfusion parameters,collateral circulation and the evaluation value of head CT angiography in all patients were analyzed.Results Head CT angiography results:①There were no abnormalities on plain scan in 27 patients,and there were obvious lesions in 101 patients.Multi-temporal CTA imaging was performed on the head and neck,and 128 patients had unilateral cerebral stenosis or even occlusion.The establishment of collateral circulation was poor in 57 patients,and good in the rest.Among all the patients,19 patients scored 1,38 patients scored 2,45 patients scored 3,and 26 patients scored 4.②In good collateral circulation group,the focal side cerebral blood flow(CBF)was lower than the healthy side,and the mean transit time(MTT)and peak time(TTP)were longer than the healthy side,with significant difference(P<0.01),but there was no significant difference between the focal side and the healthy side cerebral blood volume(CBV)(P>0.05).In the poor collateral circulation group,the CBV and CBF of the focal side were lower than those of the healthy side,while the MTT and TTP were longer than those of the healthy side,the difference was statistically significant(P<0.01).③rCBV and rCBF in the poor collateral circulation group were significantly lower than those in the good collateral circulation group,rTTP was significantly higher than that in the good collateral circulation group,the infarct area was significantly larger than that of the group with good collateral circulation group(P<0.01).Conclusion Head CT angiography can observe intracranial vascular lesions and the formation of collateral circulation.Doctors can know the cerebrovascular stenosis and occlu
作者
姚燕
YAO Yan(Department of Medical Imaging,Jingjiang People's Hospital,Taizhou,Jiangsu 214500,China)
出处
《影像研究与医学应用》
2023年第11期17-19,共3页
Journal of Imaging Research and Medical Applications
关键词
头颅CT血管成像
缺血性卒中
侧支循环
脑灌注
Head CT angiography
Ischemic stroke
Collateral circulation
Cerebral perfusion
