【摘要】 目的 探讨CT灌注成像(CTP)在评价出血型烟雾病(MMD)血流动力学中的应用价值。方法 回顾性分析20例接受过颅脑CTP检查的出血型MMD患者，比较术前出血侧和对侧不同区域灌注参数值[脑血流量(CBF)、脑血容量(CBV)、达峰时间(TTP)和平均通过时间(MTT)]的差异，并比较12例接受血管重建术患者出血侧术前与术后相对灌注参数值的差异，随访全部患者的预后情况。结果 20例患者出血侧血肿区周围CBF低于对侧，TTP及MTT高于对侧，颞叶CBF低于对侧，TTP高于对侧；12例手术患者术侧颞叶相对脑血流量(rCBF)和相对脑血容量(rCBV)较术前升高，相对达峰时间(rTTP)和相对平均通过时间(rMTT)较术前降低。以上差异均有统计学意义(P<0.05)。结论 CTP能够检测出血型MMD脑缺血的部位，可以客观评价血管重建术后脑血流动力学的变化。更多还原

【Abstract】 Objective To investigate the application value of CT perfusion(CTP) imaging in evaluating haemodynamics of hemorrhagic moyamoya disease(MMD).Methods 20 patients with hemorrhagic MMD underwent CTP examination were analyzed retrospectively. The different areas perfusion parameter values [cerebral blood flow(CBF),cerebral blood volume(CBV),time to peak(TTP),mean transit time(MTT)] of hemorrhage hemisphere were compared with the contralateral hemisphere before revascularization.In 12 patients who underwent revascularization, the relative perfusion parameter values of hemorrhage hemispheres before surgery were compared with post-surgery. All patients were followed-up.Results In 20 patients, CBF of perihematoma in the hemorrhage side were lower than that in the contralateral side, TTP and MTT were higher than the contralateral, CBF of the temporal lobe were lower than the contralateral, TTP were higher than the contralateral. In 12 patients who underwent surgery, relative CBF(rCBF) and relative CBV(rCBV) of the temporal lobe in the surgical side increased, relative TTP(rTTP) and relative MTT(rMTT) decreased. There were all significant differences(P<0.05).Conclusion CTP can detect the location of cerebral ischemia in hemorrhagic MMD and provide an objective assessment for cerebral haemodynamic changes after revascularization.更多还原