CT灌注成像对烟雾病直接搭桥术后脑血流的评估

目的应用CT灌注成像(CTP)方法探讨烟雾病颞浅动脉-大脑中动脉搭桥术对脑血流量的影响。方法选择2014年12月至2015年5月本院就诊的烟雾病患者35例,由全脑血管造影术(DSA)确诊为烟雾病。分别于术前、术后7d检查头颅CTP,在术侧及对侧根据患者的临床症状,划定相应位置作为感兴趣区(region of interest,ROI),取得各参数后,进行配对t检验。结果患者行颞浅-大脑中动脉搭桥术,94%患者脑血流量(CBF)、脑血容量(CBV)较术前增加,平均通过时间(MTT)较前缩短,达峰时间(TTP)无明显变化。术前、术后相对脑血流量(rCBF)、相对脑血容量(rCBV),相对平均通过时间(rMTT)两两比较P0.05。相对达峰时间(rTTP)P0.05。结论 CT灌注成像(CTP)对烟雾病直接搭桥术患者术前、术后脑血流的评估具有重要的临床意义。

Using CT perfusion to assess the cerebral blood flow in patients of Moyamoya disease after the superficial temporal artery-middle cerebral artery direct bypass

Objective To explore the effect of the superficial temporal artery-middle cerebral artery bypass on the cerebral blood flow in Moyamoya disease ( MMD) with CT perfusion ( CTP ) imaging.Methods Select 35 cases of Moyamoya disease patients as study from December 2014 to May 2015, diagnosed by cerebral angiography. All patients received CTP before surgery and at 7 days after cerebral revascularization.Delimit the corresponding position in the operated side and the contralateral side as region of interest(ROI), based on the patient's clinical symptoms.After obtaining the parameters, the paired t test was performed.Rseults After the superficial temporal artery-middle cerebral artery bypass, it is compared with preoperate, the cerebral blood flow ( CBF) and cerebral blood volume ( CBV) for 94%of patients was increased.And mean transit time ( MTT) was shorten ,but time to peak (TTP) had no obvious change before treatment.Relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), and relative mean transit time (rMTT) values were less than 0.05.On the contrary, relative peak time (rTTP) value was more than 0.05.Conclusion There is of great clinical significance, which CT perfusion imaging (CTP) to evaluate cerebral blood flow in Moyamoya disease patients who underwent direct bypass surgery.