颈动脉海绵窦瘘介入治疗前后的DSA血流动力学参数评价  

Preliminary application of DSA parametric imaging in evaluating the hemodynamics of brain after transcatheter embolization for carotid cavernous fistula

作　　者：蔡清源[1] 曹稳福 蔡驰[1] 郑屏萍 朱玲玲[1] 陈济铭[2] 

机构地区：[1]福建医科大学医学技术与工程学院影像系,福建福州350004 [2]福建医科大学附属第一医院介入科,福建福州350005

出　　处：《中国临床医学影像杂志》2012年第11期773-777,共5页Journal of China Clinic Medical Imaging

基　　金：福建医科大学大学生创新性实验计划项目(C10084)

摘　　要：目的:用DSA参数性成像评价颈动脉海绵窦瘘(Carotid cavernous fistula,CCF)栓塞治疗前后脑血流灌注及脑血流动力学的改变。方法:应用截图软件及Photoshop软件对图像进行处理。分别获得颈内动脉、脑组织及上矢状窦感兴趣区(ROI)的血流动力学参数,比较栓塞治疗前、后每个区域各参数的变化。血流动力学参数包括:栓塞前、后各区域ROI的最高强化值(PV),对比剂出现时间(TA),相对平均通过时间(RMTT),达峰时间(TP),相对脑循环时间(RTCC)。应用配对t检验进行统计学分析。结果:①患侧脑组织ROI内PV、TP、TA、RMTT、RTCC术前分别为40.75±2.99、(1.85±0.39)s、(0.48±0.36)s、(2.00±0.80)s、(1.30±0.55)s,术后分别为56.50±5.69、(2.95±0.13)s、(0.85±0.31)s、(2.88±0.74)s、(3.23±0.67)s,上述参数术前术后差异均有统计学意义(t值分别为9.26、8.12、5.00、5.30、9.97,P<0.05);②患侧颈动脉ROI内PV、TP术前分别为77.00±10.68、(0.88±0.22)s,术后分别为98.00±3.67、(1.38±0.10)s,上述参数术前术后差异均有统计学意义(t值分别为4.60、3.69,P<0.05)。患侧颈动脉ROI内TA、RMTT术前分别为(0.26±0.19)s、(1.45±0.40)s,术后分别为(0.36±0.21)s、(2.08±0.60)s,上述参数术前术后差异无统计学意义(t值分别为2.45、1.33,P>0.05)。结论:DSA参数性成像技术在栓塞前、后所得参数变化能够反映出CCF栓塞后脑血流灌注的改善。Objective: To evaluate the changes of cerebral perfusion and hemodynamics in the patients with carotid cavernous fistula(CCF) after transcatheter embolization with the technique of DSA parametric imaging.Methods: The images were processed by Photoshop and Screenshot software in personal computer.The following parameters of the ROIs in the internal carotid artery,brain tissue,superior sagittal sinus were acquired,respectively.These parameters includes: the peak value(PV) of brain pre-and post-embolization,and the parameters including time of appearance(TA),relative mean transit time(RMTT),time to peak(TP) and relative time of cerebral circulation(RTCC) were also evaluated,respectively.The results were statistically evaluated by matched-t test.Results: ① Before the operation,the values of PV,TP,TA,RMTT,RTCC of the brain were 40.75±2.99,(1.85±0.39) s,(0.48±0.36) s,(2.00±0.80) s,(1.30±0.55) s,respectively;after the operation,the values of the abovementioned parameters were 56.50±5.69,(2.95±0.13) s,(0.85±0.31) s,(2.88±0.74) s,(3.23±0.67) s,respectively;the difference of the parameters pre-and post-operation were statistically significant(t=9.26,8.12,5.00,5.30 and 9.97;P<0.05).②Before the operation,the values of PV,TP in the internal carotid artery were 77.00±10.68,(0.88±0.22) s,respectively;after the operation,the values of PV,TP in the internal carotid artery were 98.00±3.67,(1.38±0.10) s,respectively;the difference of the parameters pre-and post-operation were statistically significant(t=4.60,3.69;P<0.05).Before the operation,the values of TA,RMTT in the internal carotid artery were(0.26±0.19) s,(1.45±0.40) s,respectively;after the operation,the values of TA,RMTT in the internal carotid artery were(0.36±0.21) s,(2.08±0.60) s,respectively;there were no statistical significance(t=2.45,1.33;P>0.05).Conclusion: DSA parametric imaging can be used to evaluate the changes of cerebral perfusion and hemodynamics in CCF before and after transcatheter embolization.

关 键 词：颈动脉海绵窦瘘 血管造影术 数字减影 

分 类 号：R543.4[医药卫生—心血管疾病] R814.43[医药卫生—内科学]