氙CT脑血流成像在颞浅动脉-大脑中动脉搭桥术中的应用价值

目的:探讨氙CT脑血流成像评价缺血性脑血管病颅内外血管搭桥术的价值。方法:10例颈内/大脑中动脉闭塞患者实施颞浅动脉-大脑中动脉搭桥术前、术后均行氙CT检查,其中8例于术前行乙酰唑胺负荷试验。对药物负荷前后以及手术前后脑血流量(CBF)进行定性和定量比较分析。结果:10例患者术前病变侧CBF均有降低,行乙酰唑胺负荷试验的8例患者用药后4例CBF降低更明显,其余4例CBF无明显变化或仅轻度增加。术后复查氙CT有8例患者CBF较术前增加,2例CBF较术前降低,手术前后病变区CBF值有显著性差异(P<0.05)。结论:氙CT脑血流成像能够定性、定量评价颈内/大脑中动脉闭塞的脑血流情况和脑血管储备能力,对指导颅内外血管搭桥术和评价疗效具有重要价值。

Application value of xenon CT cerebral blood flow imaging in STA-MCA bypass surgery

Objective:To evaluate the value of XeCT cerebral blood flow(CBF) imaging in extracranial-intracranial arterial bypass surgery in patients with ischemic cerebrovascular disease.Methods:XeCT was performed on 10 patients with ICA/MCA occlusion before and after STA-MCA bypass surgery.Acetazolamide test was performed on 8 patients before surgery.The CBF was measured,the qualitative and quantitative analysis were carried out before and after surgery and acetazolamide test.Results:The decreased CBF on affected side was found in 10 patients.In 8 patients performed acetazolamide test,CBF decreased more significantly in 4 cases and had no obvious changes in 4 cases after the administration of acetazolamide.In 10 patients,the value of CBF significantly increased in 8 cases and decreased in 2 cases after surgery.There was statistically significant difference between the value of CBF before and after surgery(P<0.05).Conclusion:XeCT could provide measurement of CBF and vascular reserve capacity in patients with ICA/MCA occlusion,and plays an important role in selecting indication and evaluating effect of extracranial-intracranial arterial bypass surgery.