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| 能谱计算机断层扫描容积螺旋穿梭扫描技术在烟雾病中的初步应用研究 | |
| 引用本文： | 张亚男,高培毅,张东,顾卫彬,马淑杰,薛静. 能谱计算机断层扫描容积螺旋穿梭扫描技术在烟雾病中的初步应用研究[J]. 中国卒中杂志, 2013, 8(2): 92-99 |
| 作者姓名： | 张亚男 高培毅 张东 顾卫彬 马淑杰 薛静 |
| 作者单位： | 1100050 北京首都医科大学附属北京天坛医院放射科2北京市神经外科研究所3磁共振成像脑信息学北京市重点实验室（NO：BZ0133）4首都医科大学附属北京天坛医院神经外科中心/脑血管病中心 |
| 基金项目： | “十二五”国家科技支撑计划项目（2011BAI08B09）北京市科技新星计划（2007B047） |
| 摘 要： | 目的 探讨能谱计算机断层扫描（computed tomography，CT）容积螺旋穿梭扫描技术在烟雾病患者血管和灌注成像中的应用价值。方法 对4例术前、11例术后的烟雾病患者行容积螺旋穿梭扫描检查，获得四维CT血管成像及全脑CT灌注成像。采用CT平扫分型、颈内动脉分期、侧支循环分类、烟雾状血管丰富程度分期、CT灌注异常分期及Alberta卒中早期CT评分的评估标准，分左右大脑半球综合评价烟雾病的脑实质和脑血管病变。结果 术前4例烟雾病患者，8个半球中的5个半球（62.5%）处于颈内动脉分期的III期；本组侧支循环主要来源于颅底血管网（46.1%）；梗死分期中，8个半球（100%）出现异常，其中7个半球（87.5%）处于梗死前期的Ⅱ期，且Alberta卒中早期CT评分均在10分以上。术后11例（22个半球）患者均行颞浅动脉-大脑中动脉搭桥术，其中左侧6例，右侧4例，双侧1例，吻合血管通畅率为100%；梗死分期中19个半球（86.4%）出现异常，其中10个半球（45.5%）处于II期、8个半球（36.4%）处于Ⅲ期。结论 能谱CT容积螺旋穿梭技术可以同时获得四维CT血管成像及全脑CT灌注成像，能对判断烟雾病患者的动脉分期、侧支循环、脑灌注情况、术后血管吻合等影像学信息发挥重要作用。 |
| 关 键 词： | 烟雾病 能谱计算机断层扫描 |
| 收稿时间： | 2012-10-10 |
Preliminary Application Study of Spectral Computed Tomography Volume Shuttle Scanning Technique in Moyamoya Disease |
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| ZHANG Ya-Nan,GAO Pei-Yi,ZHANG Dong,GU Wei-Bin,MA Shu-Jie,XUE Jing.. Preliminary Application Study of Spectral Computed Tomography Volume Shuttle Scanning Technique in Moyamoya Disease[J]. Chinese Journal of Stroke, 2013, 8(2): 92-99 | |
| Authors: | ZHANG Ya-Nan GAO Pei-Yi ZHANG Dong GU Wei-Bin MA Shu-Jie XUE Jing. |
| Affiliation: | *Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing 100050, China |
| Abstract: | Objective To investigate the value of spectral computed tomography(CT) volume shuttle scanning technique in assessment of vascular status and perfusion in patients with moyamoya disease. Methods Spiral CT volume shuttle scanning was performed in 4 preoperative cases and 11 postoperative cases with moyamoya disease, to obtain four dimensional computed tomography angiography(CTA) and whole brain CT perfusion images. The evaluation standards of noncontrast CT classification, internal carotid artery stage, collateral circulation classification, rich puff-like network stage, abnormal CT perfusion stage and Alberta Stroke Program Early CT Score were applied to analyze cerebral parenchyma and vascular lesions of moyamoya disease in left and right cerebral hemispheres. Results In 4 preoperative patients(8 hemispheres) with moyamoya disease, 5(62.5%) of 8 hemispheres were in stage Ⅲ of internal carotid artery stage. In this group, the collateral circulation(46.1%) mainly originated from skull base vascular network. In addition, 8 hemispheres(100%) appeared abnormal on computed tomography perfusion(CTP), 7 of which(87.5%) were in pre-infarction stage II, and had Alberta Stroke Program Early CT Score more than 10 points at the same time. In 11 cases(22 hemispheres) who underwent superficial temporal artery to middle cerebral artery bypass, 6 were performed on the left, 4 were completed on the right and 1 were double,whereas the bypass patency rate was 100%. Moreover, the infarction stage of 19 hemispheres(86.4%) were abnormal, in which 40.1%(9/22) were Ⅱ stage and 36.4%(8/22) were Ⅲ stage, respectively. Conclusion Four dimensional CT angiography and whole brain CT perfusion are obtained by spectral CT volume shuttle scanning technology. The images have great values for the assessment of internal carotid artery stage, collateral circulation, graft patency and cerebral hemodynamics changes postoperatively. |
| Keywords: | Moyamoya disease Spectral computed tomography |
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