CT脑灌注参数预测非体外循环下冠状动脉旁路移植术后认知障碍

目的探讨320排动态容积CT脑灌注参数变化对预测非体外循环下冠状动脉旁路移植术(OPCAB)后认知功能障碍(POCD)的价值。方法选择将要接受OPCAB的患者105例,术前进行CT脑灌注检查,手术前后神经系统查体并在术后确认有无POCD的发生。根据术后是否发生POCD分为POCD组和非POCD组,组间进行脑灌注参数单因素分析,根据ROC曲线计算CT脑灌注参数变化率对预测术后POCD发生的最佳截点。结果术后发生POCD发病率为15.24%(16/105)。POCD组与非POCD组的颞叶和额叶局部达峰时间变化率、颞叶局部对比剂平均通过时间变化率、颞叶延迟相变化率差异有统计学意义(P0.05)。颞叶rTTP变化率23%为本研究人群术后发生POCD的最佳截点,可预测术后POCD发生。结论 OPCAB术前接受320排CT脑灌注检查有助于发现术后POCD患者。

CT cerebral perfusion parameters in prediction of postoperative cognition disorders of off-pump coronary artery bypass grafting

Objective To explore the value of 320 row dynamic volume CT cerebral perfusion in prediction of postoperative cognitive dysfunction (POCD) of off-pump coronary artery bypass grafting (OPCAB). Methods A total of 105 patients undergoing elective OPCAB were enrolled. All patients underwent cerebral perfusion imaging before operative and nervous system assessment before OPCAB. Patients were divided in to POCD group and non-POCD group according to whether or not existing POCD, and single factor analysis of cerebral perfusion parameter in two groups were carried out, the best cut point of cerebral perfusion parameters change rate in prediction of POCD were calculated. Results The total incidence rate of postoperative cognition disorders was 15.24% (16/105). Change rate of regional time to peak in temporal lobe, frontal lobe, change rate of regional mean transit time in temporal lobe, temporal delay phase between two groups had statistical significance (P<0.05). It was the best cut point to predict the incidence of POCD when change rate of rTTP in temporal lobe was 23%. Conclusion 320 row dynamic volume CT cerebral perfusion is valuable for prediction of POCD.