摘要
目的：利用CT灌注成像评价颅内外动脉狭窄血管支架置入术前后的脑血流动力学改变。方法：颅内外血管支架置入术前后做CT灌注成像检查的病人9例，比较手术前后MTT图、CBF图及CBV图的变化。结果：9例病人中3例为单支动脉狭窄，1例术前存在供血区缺血改变，术后复查CT灌注图像缺血区无明显改善，另2例术前术后未见脑缺血改变。6例为多支动脉狭窄，其中4例存在一侧颈内动脉狭窄而另一侧颈内动脉闭塞，术前CT灌注图像示1例双侧缺血；3例闭塞侧缺血，狭窄侧无缺血。术后复查双侧缺血病例术侧缺血有轻度改善，而对侧血管闭塞侧缺血加重；3例闭塞侧缺血的病例2例闭塞侧缺血加重，1例术前后无变化。术后病人均无合并症发生。结论：CT灌注成像能在血管支架置入术后早期即可显示出脑血流动力学的变化，是一种简单方便了解手术对脑循环影响的影像学方法。
Abstract
Objective: To evaluate cerebral hemodynamics of pre- and post-arterial stenting for intracranial and extracranial artery stenosis by CT perfusion imaging. Methods: CT perfusion imaging was performed in 9 patients with intracranial and extracranial stenosis, the comparison of perfusion maps of MTT, CBF and CBV between pre- and post-stenting technique were observed. Results: Three of the 9 patients had single artery stenosis. In 1 case there was cerebral ischemic area, after stenting there was no improvement and in the other 2 cases no ischemic area was noticed either pre- or post-stenting. In 6 patients there were multi-arterial stenosis. In 4 patients the internal carotid artery was stenosed on one side with occlusion of the contralateral counterpart. Pre-stenting CT perfusion showed bilateral cerebral ischemia, 3 cases had ischemia on the occlusive side, no cerebral ischemia on the stenosed side. Post-stenting CT perfusion showed the case with bilateral cerebral ischemia had improvement on the stenting side but ischemia aggravated on the contralateral side. In the 3 cases with arterial occlusion, the ischemia aggravated in 2 cases and the other case had no change. There were no post-stenting complications. Conclusion: CT perfusion can show early hemodynamic changes after stenting. It is a simple and convenient technique for evaluating the cerebral hemodynamics after arterial stenting.
关键词
颈动脉狭窄 /
支架 /
体层摄影术 /
X线计算机
Key words
carotid stenosis /
stents /
tomography /
X-ray computed
高思佳;石 强;梁传声;刘静红;张妍芬;王忠辉;徐 克.
T灌注成像在颅内外动脉狭窄支架置入术随访中的初步临床应用[J]. 中国临床医学影像杂志. 2007, 18(5): 315-318
GAO Si-jia;SHI Qiang;LIANG Chuan-sheng;LIU Jing-hong;ZHANG Yan-fen;WANG Zhong-hui;XU Ke.
Preliminary clinical application of CT perfusion imaging in the evaluation of pre- and post-stenting in intracranial and extracranial arterial stenosis[J]. Journal of China Clinic Medical Imaging. 2007, 18(5): 315-318
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