氙CT测定合并脑血管狭窄的缺血性脑血管病患者局部脑血流量的研究

目的 通过氙CT（Xenon computer tomography，Xe-CT）检查，研究合并有脑血管狭窄的缺血性脑血管病患者局部脑血流量（regional cerebral blood flow，rCBF）特点。方法 正常对照组10例，病例组22例。对所有入组对象进行Xe-CT检查，通过手工划分和皮层6分法分别测定全脑、半球、各血管分布区及各血管分布区皮层rCBF，并进行如下数据分析：①对照组各划分区域自身rCBF对比分析；②病例组各划分区域自身rCBF对比分析；③病例组与对照组各划分区域rCBF对比分析。结果 正常对照组两侧大脑半球rCBF相当，分布较为平衡。用各划分方法测定并比较两侧各大血管供应区rCBF，结果差异无统计学意义。病例组与对照组进行对比发现：①病例组全脑静息rCBF与正常对照组差异无统计学意义（38.9±10.3 ml·100 g-1·min-1 vs 44.7±7.1 ml·100 g-1·min-1，P >0.05）。②病例组两侧大脑半球rCBF差异度高于对照组（7.2±5.6 ml·100 g-1·min-1 vs 3.2±2.5ml·100 g-1·min-1，P =0.008)。③手工法与皮层6分法均显示病例组责任大脑中动脉（middle cerebral artery，MCA）支配区静息rCBF低于对照组相应区域。左侧责任MCA与对照组左侧MCA支配区域比较有统计学差异（34.3±11.2 ml·100 g-1·min-1 vs 48.1±6.4 ml·100 g-1·min-1，P =0.03)。病例组自身rCBF对比后发现：皮层6分法所测得责任侧MCA皮层区域rCBF显著低于对侧相应区域（45.8±15.2 ml·100 g-1·min-1 vs 55.4±14.5 ml·100 g-1·min-1，P =0.039)。结论 使用Xe-CT测量脑血流量，并通过手工划分全脑、半球、责任血管区域，联合软件自带6分法分析图像，反映出脑血流灌注下降是合并脑血管狭窄的缺血性脑血管病患者的重要特点，它与脑血管狭窄存在一定联系。

Evaluation of rCBF by Xenon Computer Tomography in Ischemic Stroke Patients with Cerebrovascular Stenosis

Objective To evaluate the regional cerebral blood flow（rCBF） in ischemic stroke patients with cerebrovascular stenosis by Xenon-enhanced computer tomography（CT）. Methods Thirty-two subjects participated in this study. Twenty-two of them were selected from the inpatients with cerebrovascular stenosis who had experienced ischemic stroke in the past 6 months. The other ten were normal volunteers. All subjects were examined by Xenon-enhanced CT. Four image analysis methods were applied to rCBF, including the manual analysis of whole brain, cerebral hemispheres, the region of middle cerebral HYPERLINK ＂http：//www.iciba.com/ artery/＂／t＂_blank＂ artery and the analysis of related cortex by software. Results In control group, the perfusion in each regions was in good balance. Compared two groups, we found：There was no significant difference in resting rCBF of whole brain（38.9±10.3） vs （44.7±7.1） ml.100 g^-1.min^-1, P〉0.05]. The difference of two cerebral hemispheres in case group was significantly higher than that in control group（7.2±5.6） vs （3.2±2.5） ml.100 g^-1·min^-1, P=0.008]. The resting rCBF of criminal MCA region in case is lower than that in control, significantly in left criminal MCA regi on（34.3±11.2） vs （48.1±6.4） ml-100 g^-1.min^-1, P=0.03]. In case group the rCBF of cortexin criminal MCA region divided by software was significantly lower than the contrast side（45.8±1.5.2） vs （55.4±14.5） ml.100 g^-1.min^-1, P=0.039]. Conclusion：The application of Xenon CT is useful to measure rCBF. The manual analysis of whole brain, cerebral hemispheres, the region of MCA and the analysis of related cortex by software make it clear that the stenosed cerebral artery related rCBF decrease is an significant character in ischemic stroke patients.