【摘要】 目的:应用256层螺旋CT探讨颈内动脉狭窄和闭塞与脑灌注降低的相关性。方法:对76例患者进行CTA和CTP联合检查,根据CTA图像选出颈内动脉无狭窄者为对照组,其余患者进行颈内动脉狭窄分级,分轻、中、重三级,每级独立分析研究。所有患者均选择感兴趣区进行脑灌注成像CBV、CBF、MTT、TTP测量,单侧颈内动脉狭窄者病变侧与健侧对比,进行配对t检验。双侧颈内动脉狭窄者与对照组对比,进行独立样本t检验。结果:颈内动脉无狭窄者共15例,CBV CBF MTT TTP值分别为(分水岭区2.5±0.6;38±12;5.4±0.6;21±6。基底节区5.5±0.4;95±15;3.2±1.1;20±5)。单侧颈内动脉狭窄者共33例,其中轻中度狭窄者各为12例,且CBV、CBF、MTT、TTP四项差异均无统计学意义(P>0.05),重度狭窄者9例,分水岭区CBF、MTT差异有高度统计学意义(P<0.01),TTP差异有统计学意义(P<0.05),CBV差异无统计学意义(P>0.05)。基底节区MTT差异有高度统计学意义(P<0.01),CBF差异有统计学意义(P<0.05),CBV、TTP差异无统计学意义(P>0.05)。双侧颈内动脉狭窄者共28例,重度狭窄者11例,CBF、MTT差异有统计学意义(P<0.05)。结论:受侧枝循环等多种因素影响,颈内动脉重度狭窄或闭塞与脑内血流灌注降低有相关性,轻中度狭窄与脑灌注降低无明显相关性。更多还原

【Abstract】 Objective:To discuss the correlation of carotid artery stenosis and blocking with cerebral perfusion reduction on 256 spiral CT.Methods:76 patients underwent joint inspection of CTA and CTP.We selected the patients with no carotid artery stenosis as control group according to CTA images,the remaining patients were divided into three levels: mild,moderate and severe according to the degree of carotid artery stenosis,and each level was analysed,independently.All patients were selected the interest region to process image measurements of CBV,CBF,MTT,TTP.We contrasted the lesion side and uninjured side of patients with unilateral carotid artery stenosis and contrasted the patients with bilateral carotid artery stenosis by t test.Results:There were 15 cases patients with no carotid artery stenosis,the value of CBV CBF MTT TTP were(watershed area 2.5±0.6;38±12;5.4±0.6;21±6 basal ganglia 5.5±0.4;95±15;3.2±1.1;20 ±5).There were 33 cases with unilateral carotid artery stenosis.Among these,there were 12 cases with mild to moderate stenosis,and no statistically difference of each CBV,CBF,MTT,TTP(P>0.05).There were 9 cases with severe stenosis,in watershed area there were high statistically differences of CBF,MTT(P <0.01),statistically difference of TTP(P<0.05),no statistically difference of CBV(P>0.05).In basal ganglia,there were high statistically difference of MTT(P<0.01),statistically difference of CBF(P<0.05),no statistically differences of CBV,TTP(P>0.05).There were 28 cases patients with bilateral carotid artery stenosis.There were 11 patients with severe stenosis,and statistically difference of CBF,MTT(P<0.05).Conclusion:Affected by collateral circulation and other factors,there is correlation of internal severe carotid artery stenosis or occlusion with the blood perfusion reduction,but no apparent correlation of mild to moderate stenosis with cerebral perfusion reduction.更多还原