大脑中动脉狭窄或闭塞的形态学与血流动力学评价

目的　利用灌注磁共振和血管造影技术分析大脑中动脉狭窄或闭塞的形态学和血流动力学特点。方法　 2003 -03 ~2004-04我们收治了 41例单侧大脑中动脉狭窄或闭塞的患者,其中男 33例,女 8例;年龄 24~61岁,平均 (43. 30±4. 37)岁,借助灌注磁共振和血管造影技术对其形态学和血流动力学特点进行评价。结果　所有患者局部脑血流量没有显著性降低,但大脑中动脉分布区灌注明显延迟,且随着狭窄程度加重而明显,侧枝循环对分水岭区的灌注障碍有所代偿,而对大脑中动脉分布区影响不大。结论　单侧大脑中动脉狭窄时,灌注磁共振技术可以准确评价患者的血流动力学状况,而此时的血流动力学障碍与形态学特点有明显的关系。     

单侧颈内动脉狭窄或闭塞患者的侧枝循环与脑缺血的关系探讨

目的:探讨单侧颈内动脉狭窄或闭塞患者侧枝循环代偿与脑缺血的关系.方法:将22例单侧颈内动脉狭窄或闭塞患者根据血管受累程度及有无侧枝代偿分为有侧枝代偿颈内动脉狭窄组和颈内动脉闭塞组及无侧枝代偿颈内动脉狭窄组三组,分别对三组患者的脑血流灌注显像结果进行对比分析.结果:13例单侧颈内动脉狭窄患者中6例有侧枝代偿,7例无侧枝代偿.9例单侧颈内动脉闭塞患者均有侧枝代偿.当颈内动脉狭窄或闭塞时,侧枝代偿常见于脑灌注损伤较重的患者,三组患者比较,患侧额、颞、顶叶皮层的血流灌注有显著性差异(t=-2.613,P=0.020;t=-2.489,P=0.030;t=-2.737,P=0.016),而枕叶、基底节及丘脑的血流灌注无明显差异(P＞0.05).结论:脑灌注损伤与血管狭窄程度及侧枝代偿有关,尽管脑血管造影检查与脑血流灌注显像结果间不能直接对比,但联合应用两种方法可对脑缺血有一个全面认识.     

双侧颈内动脉狭窄的侧枝循环特点分析

目的 :利用血管造影技术分析双侧颈内动脉狭窄或闭塞的形态学特点。方法 :2 0 0 0年 9月～ 2 0 0 4年 4月 ,我们收治了 15 5例单侧大脑中动脉狭窄或闭塞的患者 ,其中男 10 9例 ,女 4 6例 ;年龄 2 9～ 73岁 ,平均 4 7.6± 6 .2 4岁 ,借助血管造影技术对其形态学特点进行评价。结果 :双侧颈内动脉狭窄或闭塞时 ,最常见各种方式的综合代偿 ,单纯依赖Willis环者较少 ,但在单侧闭塞伴对侧狭窄的患者中 ,前交通动脉代偿较多。单侧闭塞伴对侧狭窄的患者多发生狭窄侧脑梗死。侧枝循环代偿尤其是后交通动脉代偿可以防止梗死发生 ,但前交通动脉代偿时梗死的发生率反而增高。结论 :双侧颈内动脉狭窄或闭塞时 ,应该深入分析血管形态学变化 ,判断其发生缺血事件的危险性 ,从而给予针对性的治疗。     

一站式CT灌注成像评估单侧颈内动脉重度狭窄或闭塞患者颅内血流动力学改变及Willis环侧支循环情况

【摘要】目的：通过对单侧颈内动脉重度狭窄或闭塞患者行脑CT灌注成像联合CTA一站式扫描,对其脑血流动力学改变及Willis环侧支循环代偿作用进行评价,为临床血管再通治疗提供血流动力学依据。方法：对40例经颈部血管超声或头颈CTA检查确定为单侧颈内动脉重度狭窄或闭塞患者（狭窄率>70%）行320排CTPI检查,重建灌注参数图及4D-CTA图。在基底节层面选取大脑前动脉供血区、大脑中动脉供血区及前、后分水岭区作为感兴趣区行灌注参数测量,包括脑血容量（CBV）、脑血流量（CBF）、平均通过时间（MTT）和达峰时间（TTP）,对患侧与健侧的各项灌注参数进行对比分析。根据CTA图将Willis环分为开放组及未开放组,对两组的dTTP（患侧TTP-健侧TTP）、dMTT、rCBF（患侧CBF/健侧CBF）及rCBV进行比较,采用χ2检验对比分析两组间各个兴趣区的缺血程度（rCBF＜80%为重度,＞80%为轻度）,评价Willis的代偿能力。结果：与健侧比较,患侧脑区MTT、TTP延长,CBV增大,CBF略下降,其中在大脑中动脉供血区和前、后分水岭区CBV、MTT、TTP差异有统计学意义（P＜0.05),大脑前动脉供血区MTT、TTP差异有统计学意义（P＜0.05）。Willis环未开放组各兴趣区dTTP、dMTT、rCBV和rCBF均高于开放组。仅前分水岭区的脑缺血程度与Willis环是否开放有相关关系（P=0.001）。结论：单侧颈内动脉重度狭窄及闭塞患者的患侧脑组织MTT、TTP延长,部分脑区CBF下降,处于低灌注状态;Willis环对患侧有一定的代偿作用,在前分水岭区代偿作用明显;CTPI可以为颈内动脉重度狭窄或闭塞患者提供血管再通依据。     

经颅多普勒对颈内动脉颅外段重度狭窄或闭塞的颅内血流动力学分析

目的研究经颅多普勒超声（TCD）对颈内动脉颅外段重度狭窄或闭塞后颅内血流动力学参数的变化，探讨其临床应用价值。方法对32例经TCD诊断为颈内动脉颅外段重度狭窄或闭塞患者，分析其双侧大脑中动脉（MCA）、大脑前动脉（ACA）、大脑后动脉（PCA）的收缩期峰值流速（PSV）及血管搏动指数（P1），判断侧支循环开放类型，并以30例正常体检人群作为对照组，所得结果进行统计学分析。结果一侧颈内动脉颅外段重度狭窄或闭塞后，其颅内血流参数与正常对照组比较，存在明显的不对称性，经统计学t检验，差异有显著意义。TCD检测侧支循环开放例数与DSA比较，经统计学X^2检验，二者无差异（P〉0．05）。结论TCD能准确地检测到颈内动脉颅外段重度狭窄或闭塞后颅内血流动力学的变化，为临床选择治疗方法及判断预后提供有价值的信息。     

脑血流断层灌注显像评估颅内动脉闭塞患者的血运情况

目的分析颅内动脉重度狭窄或闭塞后脑组织血流灌注情况,并评估预后。方法收集海军总医院神经内科2014年3月—2015年11月收治的25例单侧或双侧颅内动脉重度狭窄或闭塞患者,男性14例、女性11例,年龄22～71岁。所有患者经数字减影脑血管造影(digital subtraction angiography,DSA)或CT血管造影确诊,99mTc 双半胱乙酯单光子发射型计算机断层扫描完成脑血流灌注显像,分析患者一般临床特点及影像学资料。结果经DSA发现颅脑已建立侧支循环代偿供血系统13例。单侧皮质区血流灌注局限性减低22例,其中伴单侧基底节区血流轻度减低10例、伴单侧小脑灌注减低3例、伴单侧丘脑灌注减低9例;未见异常3例。入院时美国国立卫生研究院卒中量表评分平均1.2分,经治疗后美国国立卫生研究院卒中量表评分平均0.5分。结论采用单光子发射型计算机断层扫描脑血流灌注显像可有效评估颅内血管重度狭窄或闭塞后的局部脑动脉血流灌注,安全有效,尤其有助于进一步评估DSA检查未见局部代偿血管形成患者的脑组织血流灌注。     

MR灌注成像在颈内动脉和大脑中动脉狭窄与闭塞的应用研究

目的 探讨单侧颈内动脉（ICA）／大脑中动脉（MCA）慢性重度狭窄、闭塞患者的MR脑灌注成像（PWI）表现及其应用价值,分析PWI表现与动脉狭窄程度的关系。资料与方法 90例单侧ICA／MCA慢性重度狭窄或闭塞患者行MRPWI检查,计算出有关脑灌注参数图,包括相对脑血流量（rCBF）、相对脑血容量（rCBV）、相对平均通过时间（rMTT）和达峰时间（TTP）图,对PWI表现进行定性和定量分析,并作病变侧与对侧对比。62例单侧ICA重度狭窄或闭塞、28例单侧MCA重度狭窄或闭塞患者分别为重度狭窄和闭塞两组,对脑灌注结果与动脉狭窄程度的关系进行分析。结果 90例ICA／MCA慢性重度狭窄或闭塞患者,PWI均发现灌注异常,表现分为3期：l期3l例,表现为TTP、rMTY延迟,rCBF和rCBV正常;2期41例,表现为TTP、rMTT延迟,rCBF正常．rCBV轻度增高;3期18例,表现为TTP、rMTY延迟,rCBF、rCBV轻度下降。病变区rCBV、rMTY和TTP与对侧比较有显著性差异（P〈0．01）,PWI表现3期之间rCBF无显著差异（P〉0.05）,rCBV、rMTT、TTP均有显著性差异（P〈0．01）。PWI表现分期与ICA／MCA狭窄程度无明显关联性;rMTT、TTP值与ICA／MCA狭窄程度有关联性,闭塞组的rMTT、TTP值高于重度狭窄组（P〈0.01）。结论PWI检查能够显示单侧ICA／MCA慢性重度狭窄或闭塞患者脑血流动力学受损情况,区分局部低灌注的程度,对临床的诊断和治疗具有重要价值,而ICA／MCA狭窄程度不能完全预测脑血流动力学改变。     

成人烟雾病颅内出血部位及原因的MSCTA分析

目的:通过多层螺旋CT血管成像(MSCTA)探讨成人烟雾病(MMD)颅内出血的部位及原因。方法:搜集30例年龄>30岁的出血性MMD患者的临床及MSCTA资料并进行回顾性分析。结果:本组患者中脑叶出血6例,丘脑、基底节区出血15例,脑室内出血5例,蛛网膜下腔出血4例。MSCTA表现为①本组患者颈内动脉分叉以上均有不同程度的狭窄闭塞:双侧大脑中动脉狭窄闭塞20例,单侧10例;双侧大脑前动脉狭窄闭塞25例,单侧3例;双侧大脑后动脉狭窄闭塞7例,单侧3例;双侧颞浅动脉狭窄2例,单侧3例。②脑底动脉环、基底节区及病变血管周围异常增生血管网形成28例。③侧支代偿供血:大脑后动脉扩张形成软脑膜吻合支代偿22例;前交通动脉增粗,由健侧代偿供血10例;眼动脉扩张5例;颈外动脉分支动脉扩张形成穿膜支与颅内软脑膜动脉吻合8例。④合并脑动脉瘤形成11例。⑤脑出血与侧支循环的关系:15例丘脑、基底节区出血及5例脑室出血患者均见异常增生血管网;6例脑叶出血患者见软脑膜侧支代偿丰富,其中1例枕叶出血与大脑后动脉瘤破裂有关。结论:MMD出血以丘脑、基底节区及脑室出血多见。异常增生血管、扩张的侧支代偿动脉及动脉瘤破裂是脑出血的主要原因。     

用~(99m)Tc-ECD-RVR法对脑主干动脉病变患者脑循环潜能的评价

作者采用Diamox(乙酰唑胺)负荷脑血流SPECT法对脑主干动脉病变患者脑循环潜能进行评价,研究对象是MRI检查怀疑颈动脉或大脑中动脉病变、通过DSA以及多普勒检查确认其狭窄程度达70％以上的63例患者。并以24例无狭窄者为对照组来分析脑循环的潜能。63例中两侧颈内动脉狭窄或闭塞者18例,单侧颈内动脉闭塞14例,单侧颈内动脉狭窄18例,大脑中动脉狭窄或闭塞13例。做     

单侧颈内动脉狭窄或闭塞后侧支循环与脑缺血关系的研究

目的 探讨单侧颈内动脉狭窄或闭塞后侧支循环与脑缺血的关系.方法 对比分析68例单侧颈内动脉狭窄或闭塞患者(实验组)及20例脑血管DSA检查正常者(对照组)的临床资料及数字减影血管造影(DSA)表现.结果 (1)实验组68例中,狭窄或闭塞发生于颈内动脉41例、大脑中动脉17例、大脑前动脉A1段4例、大脑前动脉A1段以远6例.发现侧支循环开放代偿共109例次,其中前交通动脉32例次、后交通动脉22例次、后软脑膜吻合27例次、前软脑膜吻合19例次、眼动脉4例次、穿支动脉2例次、其他3例次.重度狭窄组与闭塞组侧支循环开放率较高,分别为72.7％、86.7％,与正常对照组差异有显著性(x2=14.029、25.301,P均＜0.001);轻、中度狭窄组侧支循环开放率较低,分别为为16.7％、20.0％,与正常对照组差异无显著性(P=0.676、P=0.551).(2)初级侧支循环开放的比例:症状组小于无症状组,差异有显著性(P=0.042);次级侧支循环开放的比例:症状组大于无症状组,差异有显著性(P =0.022).前交通动脉开放的比例:症状组小于无症状组,差异有显著性(P=0.038);后交通动脉开放的比例:症状组与无症状组无显著性差异(P=0.382).(3)Willis前环变异:症状组最高,其次为正常对照组,而无症状组变异率最低,三组间差异有显著性(P =0.032);Willis后环变异比例:三组间差异无显著性(P=0.110).(4)颈内动脉闭塞的26例,侧支血流评分:梗死组得分最低为(2.4286±0.17271)分,其次为TIA组(3.2500 ±0.2500)分,最高的为无症状组(3.7500±0.16366)分,三组间差异有显著性(F=13.903,P＜0.001).结论 DSA对侧支循环状况的分析、评估具有非常重要的价值,能为颈内动脉狭窄或闭塞的诊断、治疗、预后提供较全面的评价.     

Hemodynamic modifications in patients with symptomatic unilateral stenosis of the internal carotid artery: evaluation with MR imaging perfusion sequences

BACKGROUND AND PURPOSE: Risk of developing ischemia is higher in patients with reduced cerebrovascular reactivity than in those with preserved cerebrovascular reactivity. Therefore, we assessed cerebral hemodynamic modifications in patients with unilateral stenosis of the internal carotid artery by using perfusion-weighted MR imaging to determine if these modifications underlie or anticipate ischemic signs and symptoms. METHODS: Fifteen patients with unilateral 70-90% carotid artery stenosis were studied with digital subtraction angiography and perfusion-weighted MR imaging. Their findings were compared with those of 15 age- and sex-matched control subjects. Regional cerebral blood volume (rCBV) and mean transit time (MTT) values were calculated in the middle cerebral artery and border zone territories. RESULTS: No significant difference was noted in rCBV and MTT values between the hemispheres in the symptomatic patients. There was a significant difference in MTT values in the border zones between patients and control subjects. MR images in patients and control subjects did not reveal large territorial infarcts and did reveal similar white matter lesion burdens. CONCLUSION: There is adequate compensation of unilateral stenosis when the stenosis is less than 90%. The risk of stroke is higher in patients with stenoses exceeding 70%, mostly because of decreased collateral reserve when confronted with emboli.     

单侧大脑中动脉狭窄程度与磁共振血流灌注相关性研究

目的:探讨大脑中动脉(MCA)狭窄程度与脑磁共振灌注加权成像(PWI)的相关性。方法:30例短暂性脑缺血发作(TIA)患者行高分辨力MRI检查并判断单侧MCA狭窄程度,同时行磁共振PWI检查,并对MCA不同狭窄状态下得出的患侧和镜像侧灌注参数,包括相对脑血容量(rCBV)、相对脑血流量(rBCF)、相对平均通过时间(rMTT)、相对达峰时间(rTTP)进行定量分析。结果:30例患者中,高分辨力MRI均可显示不同程度MCA狭窄,灌注均出现异常,患侧灌注参数rCBV、rCBF、rMTT、rTTP与镜像侧比较,差异均有统计学意义(P<0.05)。MCA狭窄率与rMTT延长百分率之间呈正相关性(r=0.45,P<0.05)。结论:高分辨力MRI对MCA狭窄程度的评估与PWI灌注参数之间存在正相关性,MCA狭窄程度与PWI相结合对于评价脑组织供血有一定的指导意义。     

慢性大脑中动脉狭窄与闭塞的MR灌注成像研究

目的:探讨单侧大脑中动脉(MCA)慢性重度狭窄、闭塞患者的MR脑灌注成像表现及其应用价值.方法:28例单侧MCA慢性重度狭窄或闭塞患者行MR脑灌注成像检查,得出有关脑灌注参数图,包括相对脑血流量(rCBF)、相对脑血容量(rCBV)、相对平均通过时间(rMTT)和达峰时间(TTP)图,对灌注成像表现进行定性和定量分析.结果:28例MCA慢性重度狭窄或闭塞患者,磁共振灌注加权成像(PWI)均发现病变侧灌注异常,病变侧rCBV、rMTT和TTP与对侧比较差异有显著性意义(P＜0.01),rCBF差异无显著性意义(P＞0.05).rMTT和TTP图显示病变侧较对侧明显延迟,24例仅累及MCA供血区,4例同时累及MCA和分水岭区.结论:PWI检查能够显示单侧MCA慢性重度狭窄或闭塞患者脑血流动力学受损情况,对临床诊断和治疗具有重要价值.     

Perfusion MR neuroimaging in patients undergoing balloon test occlusion of the internal carotid artery

BACKGROUND AND PURPOSE: We sought to investigate whether the combination of conventional, diffusion-weighted, and perfusion-weighted MR imaging increases the diagnostic accuracy of balloon test occlusion of the internal carotid artery. We describe perfusion anomalies and patterns of enhancement seen in areas of altered brain perfusion during MR-monitored temporary balloon occlusion of the internal carotid artery. METHODS: Nine patients underwent balloon occlusion testing under standard angiographic conditions with continuous clinical and EEG monitoring. One patient who failed the test by clinical criteria underwent an external carotid to internal carotid bypass operation, followed by a repeat balloon test occlusion, thereby bringing the total number of procedures to 10. Patients were further imaged at 1.5 T with perfusion- and diffusion-weighted imaging as well as with conventional noncontrast and contrast-enhanced turbo fluid-attenuated inversion recovery (FLAIR) and T1-weighted sequences. RESULTS: Seven of 10 patients who tolerated unilateral carotid test occlusion without adverse clinical neurologic or EEG changes exhibited delayed first-pass transit of contrast material through the affected cerebral hemisphere, indicative of altered perfusion without significant concurrent cerebral blood flow or blood volume changes. Four of these patients and both symptomatic patients showed pial or subarachnoid contrast staining in areas of altered perfusion without abnormalities on diffusion-weighted images. CONCLUSION: Our findings indicate that MR perfusion-weighted imaging is safe and easily accomplished in a high-field-strength magnet and that contrast-enhanced turboFLAIR imaging may provide clinically useful MR imaging evidence of abnormal cerebral blood flow and subclinical ischemia.     

Multifunctional magnetic resonance imaging of cerebrovascular disease

Over the last few years magnetic resonance imaging (MRI) has developed into a multipurpose imaging technique. In addition to anatomical information, data can be obtained on perfusion, metabolism and imaging of the vascular anatomy. Especially in the field of neuroradiology the possibilities for obtaining multifunctional information from combined MR examinations are promising. In particular, stroke or stroke-related research benefits from these developments. This article reviews the current status and the potential of newly developed MR techniques with regard to the intracranial hemodynamic changes in patients with severe stenosis or occlusion of the internal carotid artery. The combination of MR angiography, perfusion-weighted MRI and MR spectroscopic imaging seems especially useful in the management of the individual patient. Received 14 April 1997; Revision received 27 June 1997; Accepted 2 October 1997     

Dynamic contrast-enhanced T2*-weighted MRI in patients with cerebrovascular disease

Our purpose was to investigate the potential of dynamic susceptibility contrast-enhanced MRI in assessing regional haemodynamics in patients with cerebrovascular disease. T2^*-weighted FLASH sequences were performed on a control group of 10 healthy subjects, 13 patients with unilateral stenosis or occlusion of the internal carotid artery and 6 patients with acute onset of neurological symptoms, the observed signal intensities being converted into concentration-time curves. A gamma-variate function was fitted to the measured concentration-time curves to eliminate effects of tracer recirculation. In each patient the two cerebral hemispheres were compared and the difference between the mean transit times and the percental change of the regional cerebral blood volume, calculated for each side. Patients with haemodynamically significant unilateral carotid obstruction can be divided into two subgroups: those with good and those with poor collateral supply. Patients with good collateral supply had a slight but not statistically significant increase in mean transit time and cerebral blood volume on the diseased side, whereas those with poor collaterals had a significant increase compared with the control group. In patients with acute onset of neurological symptoms perfusion maps clearly demonstrated the disturbed perfusion at a time when T2-weighted images were still normal. Perfusion imaging is a reliable and noninvasive method of assessing changes in cerebral perfusion in patients with unilateral carotid stenosis. This MR technique permits monitoring of haemodynamic changes during therapy and thus may become an alternative to SPECT and PET scanning. In patients with acute occlusion of a cerebral artery, perfusion imaging reveals the entire perfusion deficit before conventional MRI and thus allows early intervention. Received: 10 April 1996 Accepted: 14 June 1996     

Dynamic susceptibility contrast perfusion magnetic resonance imaging in patients with symptomatic unilateral middle cerebral artery stenosis or occlusion

PURPOSE: To evaluate cerebral hemodynamic disturbance in patients with symptomatic unilateral middle cerebral artery (MCA) high-grade stenosis or occlusion using dynamic susceptibility contrast perfusion magnetic resonance imaging (DSC-pMRI). MATERIAL AND METHODS: DSC-pMRI was performed in 28 patients with symptomatic unilateral MCA high-grade stenosis or occlusion. Hemodynamic parameters including relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), relative mean transit time (rMTT), and time to peak (TTP) were calculated and compared between the stenosed or occluded side and contralateral side. Seven of the 28 patients underwent surgery or interventional therapy, and hemodynamic changes between pre- and post-therapy were investigated. RESULTS: Prolonged rMTT and TTP were found in the stenosed or occluded MCA territories in all 28 patients. Significant differences were found in rCBV (P<0.05), rMTT (P<0.001), and TTP (P<0.001) between the stenosed or occluded side and the contralateral side. However, no significant difference was observed in rCBF (P>0.05). In the seven patients with surgical or interventional therapy, the values of rMTT and TTP significantly decreased after surgery or interventional therapy (P<0.001). CONCLUSION: DSC-pMRI may be a useful tool for evaluating and monitoring cerebral hemodynamic disturbance in patients with symptomatic unilateral MCA high-grade stenosis or occlusion.     

CTP联合CTA对慢性脑缺血患者血流动力学的评价

目的：利用CT灌注（CTP）和CT血管成像（CTA）探讨慢性脑缺血患者脑血流动力学变化及其与脑供血动脉狭窄、血管性认知功能障碍之间的关系。方法：对55例临床拟诊为慢性脑缺血的患者行常规头颅CT平扫、CTP及CTA检查,应用简易智能状态检查（MMSE）量表评定受试者的智能状态。结果：根据平均通过时间（MTT）、达峰时间（TTP）图灌注延迟范围将灌注表现分为3型：Ⅰ型为大脑中动脉和/或大脑前动脉供血区广泛性低灌注22例;Ⅱ型为分水岭区局限性低灌注21例;Ⅲ型为灌注正常12例。颈内动脉（ICA）或大脑中动脉（MCA）的重度狭窄或闭塞所致脑灌注异常（Ⅰ、Ⅱ型）明显高于轻中度狭窄者（χ^2=29.49,P〈0.01）,Ⅲ型未见ICA或MCA的重度狭窄或闭塞。ICA或MCA狭窄程度与脑灌注异常之间呈正相关（Spearman′sr=0.74,P〈0.01）。脑灌注Ⅰ、Ⅱ型患者MMSE评分均低于正常值（P〈0.01）,且以Ⅰ型为著（P〈0.01）,Ⅲ型MMSE评分正常。结论：慢性脑缺血患者脑血流低灌注与ICA或MCA狭窄程度密切相关,在血管性认知功能障碍的发病机制中起着重要作用。     

64层螺旋CT脑灌注联合CT血管造影对颈内动脉狭窄或闭塞的应用

目的探讨64层螺旋CT脑灌注(CTP)联合CT血管造影(CTA)对颈内动脉狭窄或闭塞的应用价值。方法根据病史或临床症状及体征诊断为颈内动脉及其分支的狭窄或闭塞50例患者分别行CTP和CTA扫描,评价CTP参数平均通过时间(MTT)、对比剂峰值时间(TTP)、脑血流量(CBF)、脑血容量(CBV)以及造影后颈内动脉狭窄程度。结果36例TIA患者患侧MTT延长较健侧具有显著性意义,rCBF侧较健侧无显著性意义,rCBV患侧较健侧无显著性意义。34例梗死组患者患侧MTT延长较健侧有显著性意义,rCBF患侧较健侧无显著性意义,rCBV患侧较健侧无显著性意义。结论 CTP联合CTA可以同时判断颈内动脉狭窄和脑组织局部血流灌注情况。