【摘要】 目的探讨CTP联合4D-CTA对大脑中动脉、颈内动脉狭窄患者血流动力学变化与临床症状、患者预后之间的关系。方法对28例临床上拟诊慢性缺血性脑血管病的患者行颅脑CT平扫及CTP联合4D-CTA扫描。其中8例患者于CT检查后1周~2个月内行颅脑MRI扫描随访。结果根据灌注(CTP)参数CBV(脑血容量)、CBF(脑血流量)、MTT(平均通过时间)、TTP(达峰时间)及4D-CTA显示的血管情况进行对比分析,灌注阳性者26例,阴性2例,诊断的敏感性为92.9%.4D-CTA发现9例大脑中动脉重度狭窄,2例大脑中动脉+颈内动脉重度狭窄,5例大脑中动脉闭塞,2例大脑中动脉中度狭窄,2例颈内动脉重度狭窄,5例中度狭窄,1例轻度狭窄,3例患者发现侧枝循环血管,颅脑MRI随访3例于两周至两个月内出现脑梗死。结论 CTP联合4D-CTA可以评价前循环血管情况及供血区的血流动力学变化,帮助临床选择个体化的治疗方式,及时纠正脑缺血状态,降低脑梗死发生率,评估患者预后。更多还原

【Abstract】 Objective To investigate the alteration of hemodynamics of patients with stenosis of middle cerebral artery and internal carotid artery as well as its relationship with clinical symptoms,the prognosis of these patients.Methods 28 patients with the clinically suspected chronic ischemic cerebrovascular disease underwent brain CT combined with 4D-CTA and CTP scan,of whom 8patients were subjected to the MR follow-up,at one week to two months after the CT examination.Results According to the perfusion parameters(CTP),cerebral blood volume(CBF),cerebral blood flow(MTT),mean transit time(TTP),peak time,and vascular 4D-CTA,the display situations were analyzed in this work.In these patients,there were 26 cases with positive infusion,2cases with negative infusion and the diagnostic sensitivity was92.9%.4D-CTA fund that there 9cases of severe middle cerebral artery stenosis,2cases of severe cerebral artery stenosis of internal carotid artery,5cases of middle cerebral artery occlusion,2cases of moderate stenosis,2cases of carotid artery stenosis,5cases of moderate stenosis,1case of mild stenosis,3cases of collateral vessels.As for the 3cases underwent brain MR Follow-up,cerebral infarction occurred in two weeks or within two months.Conclusion CTP combined with 4D-CTA can evaluate the hemodynamics of vascular territory,help the individualized treatment in clinic timely correct cerebral ischemia,reduce the incidence of cerebral infarction,and evaluate the prognosis of patients.更多还原