摘要
目的：研究症状性单侧颈内动脉（ICA）严重狭窄或闭塞的320排CT全脑灌注成像（CTPI）表现及血流动力学模式。资料与方法：回顾分析23例症状性单侧ICA严重狭窄（>70%）或闭塞的患者的全脑CTPI资料，分别重建4D-CTA及CTPI参数图（脑血容量（CBV）、脑血流量（CBF）、平均通过时间（MTT）、达峰时间（TTP）及延迟（Delay）图），分别记录ICA狭窄程度、患者临床症状、有无梗死及梗死部位、CTPI参数图特点及绝对值，并对病灶侧及对侧脑区灌注参数值进行比较。结果：单侧ICA闭塞15例，严重狭窄8例。大脑中动脉（MCA）和/或大脑前动脉（ACA）分布区脑梗死13例，内侧分水岭区梗死6例，基底节区腔隙性脑梗死2例，无梗死2例。CTPI血流动力学模式有：①CBV/CBF基本正常，MTT/TTP/Delay延长（4例）；②CBV基本正常，CBF轻度下降，MTT/TTP/Delay延长（3例）；③CBV/CBF明显减低，MTT局灶缩短并周围MTT/TTP/Delay延长（16例）。统计学分析显示：病灶同侧CBV、CBF、TTP、Delay与对侧比较差异有统计学意义（P<0.05）；病灶同侧MTT与对侧比较差异无统计学意义（P=0.66）。结论：320排CT全脑容积CTA/CTPI能一次显示颅内段ICA的狭窄程度并能全面反映脑血流动力学变化，为临床治疗提供重要信息。
Abstract
Objective: To study the hemodynamic patterns demonstrated in whole brain CT perfusion images(CTPI) in patients with symptomatic severe stenosis or occlusion of intracranial internal carotid artery(ICA). Materials and Methods: The CTPI data of 23 patients with symptomatic severe stenosis(>70%) or occlusion of ICA were analyzed retrospectively. The 4 dimensional CT angiography(4D-CTA) and the parameter maps of CTPI including cerebral blood volume(CBV), cerebral blood flow(CBF), mean transit time(MTT), time to peak(TTP) and delay maps were generated in the off-line workstation by using specific software. The stenosis degree of ICA, clinical symptoms, location of infarction and features of CTPI and the values of parameter maps were recorded. Paired t-test was used to compare the values of ipsilateral with contralateral normal areas in CTP maps. Results: Fifteen patients had occlusion and 8 patients had severe stenosis of ICA. Thirteen cases had infarction in middle cerebral artery(MCA) or anterior cerebral artery(ACA) areas, 6 cases had watershed infarction, 2 cases had lacunar infarction and 2 cases had no infarction. The patterns of CTPI abnormalities included the following: ①Normal or slightly increased CBV/CBF and increased MTT/TTP/Delay time(4 csaes). ②Normal CBV, slightly decreased in CBF and decreased in MTT/TTP/Delay time(3 cases). ③Decreased obviously in CBV/CBF, decreased in regional MTT associated with prolong MTT/TTP/Delay time(16 cases). CBV, CBF, TTP and Delay values of ipsilateral side brain areas had significant difference when compared with those of contralateral brain areas(P<0.05). Conclusions: 320-row CT is a reliable technique in showing intracranial ICA stenosis and perfusion abnormalities.
关键词
脑血管意外 /
颈内动脉 /
体层摄影术 /
X线计算机
Key words
Cerebrovascular accident /
Carotid artery /
internal /
Tomography /
X-ray computed
魏新华;江新青;潘小平;王 伟;梁志伟;徐向东.
症状性单侧颈内动脉颅内段严重狭窄或闭塞全脑CT灌注成像表现模式[J]. 中国临床医学影像杂志. 2012, 23(6): 381-384
WEI Xin-hua;JIANG Xin-qing;PAN Xiao-ping;WANG Wei;LIANG Zhi-wei;XU Xiang-dong.
The whole brain CT perfusion imaging findings of symptomatic severe stenosis or occlusion of intracranial internal carotid artery[J]. Journal of China Clinic Medical Imaging. 2012, 23(6): 381-384
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