【摘要】 目的探讨多层螺旋CT(MSCT)脑灌注技术在评价颈动脉重度狭窄患者脑血液动力学变化中的临床应用价值。方法对23例颈动脉重度狭窄患者(病例组)行颅脑平扫和MSCT脑灌注检查,对脑血液动力学状态进行评价。选10例年龄匹配的志愿者作为评价CT灌注异常的标准组。结果正常组脑CT灌注结果显示左右大脑半球灌注对称。病变组颈动脉狭窄侧脑灌注异常17例,均表现为达峰时间延迟,其中7例伴有脑血容量升高,4例伴有脑血流量下降。颈动脉闭塞组(8例)和重度狭窄组(9例)灌注异常发生率差异无显著性(P=0.640)。多发狭窄组(14例)和单发组(3例)灌注异常发生率差异有显著性(P=0.045)。结论CT灌注技术可以敏感地发现颈动脉狭窄患者脑血液动力学的异常变化,具有较高的临床应用价值。更多还原

【Abstract】 Objective To study the clinical value of multi-slice spiral CT(MSCT) perfusion technique in evaluation of cerebral hemodynamics in patients with severe carotid stenooclusive lesions. Methods Twenty-three patients with severe carotid stenosis were enrolled for evaluation of cerebral hemodynamics,including 12 patients with carotid occlusion and 11 with severe carotid stenosis (>70%). Among them,16 patients had multiple arterial diseases,including contralateral carotid stenosis,vertebral arteries stenosis,and cerebral arteries stenosis or occlusion. All patients received CT perfusion examination. Ten normal persons received CT perfusion were regarded as the control group. Results Cerebral perfusion was bilaterally symmetrical in 10 normal persons. While in the patients group,cerebral hemodynamic impairments ipsilateral to the stenosis side were found by CT perfusion in 17 patients,including an delay of time to peak (TTP)(17 patients),increase of cerebral blood volume (CBV) (7 patients),and decrease of cerebral blood flow(CBF) (4 patients). No significant difference was found between occlusion group (n=8 ) and stenosis group (n=9) (P=0.640),but incidences of hemodynamic impairment were significantly higher in multiple arterial diseases group (n=14) than single arterial disease group (n=3) (P=0.045). Conclusion CT perfusion technique can sensitively reveal the cerebral hemodynamic impairments in patients with severe carotid stenooclusive diseases,and therefore valuable for clinical application.更多还原