256层螺旋CT脑灌注成像在大脑中动脉狭窄或闭塞中的应用

目的 探讨256层螺旋CT全脑灌注（CTP）联合CT血管成像（CTA）在大脑中动脉（MCA）狭窄或闭塞患者中的临床应用价值.方法 对31例患者进行CTP和CTA联合检查,按照MCA狭窄程度分为轻、中及重3级,进行病变侧与健侧的脑血流量（rCBF）、局部血容量（rCBV）、平均通过时间（MTT）及达峰时间（TTP）灌注参数对比.结果 病变侧与健侧分水岭区rCBF、MTT及TTP差异均有高度统计学意义（P＜0.05）,rCBV差异无统计学意义（P＞0.05）;基底节区rCBV、rCBF、MTT及TTP差异均有统计学意义（P＜0.05）.结论 受侧枝循环等多种因素影响,MCA重度狭窄或闭塞与脑内血流灌注降低有相关性,轻中度狭窄与脑灌注降低无明显相关性.

Application of 256 slice spiral CT perfusion imaging in middle cerebral artery stenosis or occlusion

Objective To explore the value of clinical application of 256 slice spiral CT perfusion （CTP） combined with angiography （CTA） in patients with stenosis or occlusion of middle cerebral artery（MCA）. Methods Thirty- one patients underwent joint inspection of CTA and CTE The patients were divided into three levels： mild, moderate and severe according to the degree of carotid artery stenosis. Cerebral blood flow（rCBF）, cerebral blood volume （rCBV）, mean transit time （MTT） and time to peak （TTP） of injured and the uninjured side were measured and com- pared. Results The differences of rCBF, MTT and TTP of the watershed area were statistically significant （P 〈 0.01）;there was no significant difference in rCBV（P 〉 0.05）. Basal ganglia rCBV, rCBF, MTT and TTP differences were highly statistically significant （P 〈 0.01）. Conclusions Affected by collateral circulation and other factors, there is correlation of middle cerebral artery severe stenosis or occlusion with the blood perfusion reduction, but no apparent correlation of mild to moderate stenosis with cerebral perfusion reduction.