目的：用DSA参数性成像评价颈动脉海绵窦瘘（Carotid cavernous fistula，CCF）栓塞治疗前后脑血流灌注及脑血流动力学的改变。方法：应用截图软件及Photoshop软件对图像进行处理。分别获得颈内动脉、脑组织及上矢状窦感兴趣区（ROI）的血流动力学参数，比较栓塞治疗前、后每个区域各参数的变化。血流动力学参数包括：栓塞前、后各区域ROI的最高强化值（PV），对比剂出现时间（TA），相对平均通过时间（RMTT），达峰时间（TP），相对脑循环时间（RTCC）。应用配对t检验进行统计学分析。结果：①患侧脑组织ROI内PV、TP、TA、RMTT、RTCC术前分别为40.75±2.99、（1.85±0.39） s、（0.48±0.36） s、（2.00±0.80） s、（1.30±0.55） s，术后分别为56.50±5.69、（2.95±0.13） s、（0.85±0.31） s、（2.88±0.74） s、（3.23±0.67） s，上述参数术前术后差异均有统计学意义（t值分别为9.26、8.12、5.00、5.30、9.97，P<0.05）；②患侧颈动脉ROI内PV、TP术前分别为77.00±10.68、（0.88±0.22） s，术后分别为98.00±3.67、（1.38±0.10） s，上述参数术前术后差异均有统计学意义（t值分别为4.60、3.69，P<0.05）。患侧颈动脉ROI内TA、RMTT术前分别为（0.26±0.19） s、（1.45±0.40） s，术后分别为（0.36±0.21） s、（2.08±0.60） s，上述参数术前术后差异无统计学意义（t值分别为2.45、1.33，P>0.05）。结论：DSA参数性成像技术在栓塞前、后所得参数变化能够反映出CCF栓塞后脑血流灌注的改善。
Abstract
Objective: To evaluate the changes of cerebral perfusion and hemodynamics in the patients with carotid cavernous fistula(CCF) after transcatheter embolization with the technique of DSA parametric imaging. Methods: The images were processed by Photoshop and Screenshot software in personal computer. The following parameters of the ROIs in the internal carotid artery, brain tissue, superior sagittal sinus were acquired, respectively. These parameters includes: the peak value(PV) of brain pre- and post-embolization, and the parameters including time of appearance(TA), relative mean transit time(RMTT), time to peak(TP) and relative time of cerebral circulation(RTCC) were also evaluated, respectively. The results were statistically evaluated by matched-t test. Results: ①Before the operation, the values of PV, TP, TA, RMTT, RTCC of the brain were 40.75±2.99, (1.85±0.39) s, (0.48±0.36) s, (2.00±0.80) s, (1.30±0.55) s, respectively; after the operation, the values of the above-mentioned parameters were 56.50±5.69, (2.95±0.13) s, (0.85±0.31) s, (2.88±0.74) s, (3.23±0.67) s, respectively; the difference of the parameters pre- and post-operation were statistically significant(t=9.26, 8.12, 5.00, 5.30 and 9.97; P<0.05)． ②Before the operation, the values of PV, TP in the internal carotid artery were 77.00±10.68, (0.88±0.22) s, respectively; after the operation, the values of PV, TP in the internal carotid artery were 98.00±3.67, (1.38±0.10) s, respectively; the difference of the parameters pre- and post-operation were statistically significant(t=4.60, 3.69; P<0.05)． Before the operation, the values of TA, RMTT in the internal carotid artery were (0.26±0.19) s, (1.45±0.40) s, respectively; after the operation, the values of TA, RMTT in the internal carotid artery were (0.36±0.21) s, (2.08±0.60) s, respectively; there were no statistical significance(t=2.45, 1.33; P>0．05)． Conclusion: DSA parametric imaging can be used to evaluate the changes of cerebral perfusion and hemodynamics in CCF before and after transcatheter embolization.
关键词
颈动脉海绵窦瘘 /
血管造影术 /
数字减影
Key words
Carotid-cavernous sinus fistula /
Angiography /
digital subtraction
