急性缺血性脑梗死的CT灌注成像与认知功能障碍的关系

目的探讨急性缺血性脑梗死发生后,局部脑灌注改变与血管性认知功能障碍(VCI)发生的关系。方法选择脑动脉粥样硬化性脑梗死患者69例,在发病1周内进行CT灌注扫描,3周后采用蒙特利尔认知评估量表(MoCA)对患者进行认知功能障碍的筛查,将MoCA评分<26分40例作为VCI组,MoCA评分≥26分29例作为对照组,比较2组患者的一般资料、脑梗死区局部脑血流量(CBF)和脑血流容量(CBV)与对侧正常镜像区的变化。结果与对照组比较,VCI组患者日常生活能力依赖的比例更高,脑梗死灶位于左侧和额颞顶叶的比例更高(P<0.05,P<0.01)。VCI组和对照组患者梗死区局部CBF和CBV较对侧正常镜像区均减少(P<0.05);VCI组的病灶侧CBF和CBV下降率则明显低于对照组病灶侧,差异有统计学意义(P<0.01)。MoCA评分与局部CBV和CBF呈负相关(r=-0.3758,-0.4772,P<0.01)。结论急性缺血性脑卒中后,脑血流灌注降低程度与VCI的发生有一定的关系。

Correlation between CT perfusion imaging of acute ischemic cerebral infarction and cognitive impairment

Objective To study the correlation between CT perfusion imaging of acute cerebral infarction and vascular cognitive impairment(VCI).Methods Sixty-nine patients with acute ischemic cerebral infarction(onset within one week) underwent CT perfusion scanning.Their VCI was detected by Montreal cognitive assessment(MoCA) after 3 weeks.The patients were divided into VCI group with a MoCA score <26(n = 40) and control group with a MoCA score≥26(n = 29). The general data,cerebral blood volume(CBV) and cerebral blood flow(CBF)in the affected side were compared with those in the non-affected side.Results The dependent daily living ability and the ratio of cerebral infarction at the left side and temporal lobe were higher in VCI group than in control group.The CBV and CBF were lower in the affected side than in the non-affected side of both groups.The CBV and CBF in the lesion side were significantly lower in VCI group than in control group(P<0.05).The MoCA score was negatively correlated with the local CBV and CBF (r=-0.3758,-0.4772,P<0.01).Conclusion Decreased cerebral blood perfusion is correlated with VCI in patients with acute cerebral infarction.