64层CT评价椎-基底动脉系统TIA间歇期脑血流灌注状态的价值

目的探讨脑64层CT灌注(64-SCTP)成像评价椎-基底动脉系统TIA间歇期局部脑血流灌注状态的价值。方法收集临床拟诊为椎-基底动脉系统TIA患者26例,于间歇期行64-SCTP检查,测定兴趣区及对侧相应区域局部脑血流量(rCBF)、局部脑血容量(rCBV)、平均通过时间(MTT)和达峰时间(TTP),对这些灌注参数进行半定量分析,所有患者同期进行CTA检查,CTA检查结果均经DSA证实。结果所有26例椎-基底动脉系统TIA患者中有18例CTP脑灌注异常,其患侧及对侧的平均rTTP、rMTT、rCBF差异均有显著性意义,而rCBV差异无显著性意义;CTA发现26例患者中有椎-基底动脉系统血管狭窄20例。结论以桥脑层面为基础灌注层面的64层CT灌注成像可以用于评估椎-基底动脉系统TIA患者间歇期血流灌注状态,帮助了解患者病情,结合CTA检查可以发现相关责任血管,对指导临床早期干预,预防脑梗死的发生有重要价值。

The Value of 64-slice CT in Evaluating Perfusing State of Cerebral Blood Flow in Vertebral Basilar Artery System Transient Ischemia Attack in Intermission

Objective To expore the value of 64-slice CT in evaluating perfusing state of cerebral blood flow in patients with vertebral basilar artery system transient ischemia attack(TIA) in intermission.Methods 26 cases which were diagnosed with vertebral basilar artery system TIA were collected,and 64-SCTP was performed to them in intermission.64-SCTP was used to calculate rCBF,rCBV,TTP and MTT in region of interest(ROI) and corresponding areas of the opposite side,and all the CTP parameters were semiquantitative analysised.CTA was performed to all patients,and the results of CTA were confirmed by DSA.Results 18 cases of the 26 patients were found abnormal perfusion changes by CTP,The differences of the rCBF,TTP,MTT between affected side and the contralateral side was significance(P<0.05).The differences of the rCBV(P>0.05) between both sides was not statistically significant.20 cases were found hemadostenosis in vertebral basilar artery system by CTA.Conclusion According to the base slice of pons,64-slice spiral CT perfusion in brain can be used to evaluate the hemodynamics of patients with vertebral basilar artery system TIA,and can help to evaluate blood perfusion condition of patients with vertebral basilar artery system,and can disclose vasculopathy combined with CTA.It has great value to direct early intervention and prevent cerebral infarction by clinical doctor.