320排全脑动态容积CT血管造影及灌注成像在烟雾病中的应用  

Experience of 320-slice whole brain dynamic volume CT and perfusion imaging in patients with moyamoya disease

作　　者：潘宇宁[1] 黄求理[1] 叶贤旺[1] 张杰[1] 廉艳东[1] 傅芬芬[1] 

机构地区：[1]宁波市第一医院放射科,浙江宁波315010

出　　处：《中国临床医学影像杂志》2011年第12期840-843,共4页Journal of China Clinic Medical Imaging

摘　　要：目的：探讨320排全脑动态容积CT血管造影及灌注成像在烟雾病中的应用价值。方法：18例烟雾病患者均行320排全脑动态容积CT扫描，并利用容积再现（VR）技术进行图像重组且采用电影模式观看，同时完成全脑灌注成像检查。结果：所有病例均获得良好的平扫容积图像、动态DSA图像及全脑灌注图像，均清晰显示发生狭窄、闭塞的颈内动脉及颅底异常血管网，其中双侧颈内动脉闭塞9例，单侧颈内动脉闭塞2例，单侧大脑中动脉闭塞7例，侧支血管表现为相应血管及其分支的粗大、增多及迂曲延长。全脑灌注图像中，显示平均通过时间（MTr）延长，为O．5-13．0s；局部脑血流量（rCBF）下降10例，降低幅度为26．0％。54．5％；局部脑血容量（rCBV）显示有8例在正常范围内，4例出现不同程度的降低（30．0％-68．5％）。结论：320排全脑动态容积CT成像可以动态观察颅内血管的形态及动态血流信息，全脑灌注图像可以量化评价烟雾病患者全脑灌注情况，真正实现了全脑一站式容积扫描．对于烟雾病的诊断和评价脑组织血供具有极高的临床应用价值。Objective： To evaluate the value of 320-slice whole brain dynamic volume CT angiography and CT perfusion imaging in moyamoya disease. Methods： Eighteen cases with moyamoya disease were examined with 320-slice whole brain dynamic volume CT. Imaging data were generated with volume rendering reconstruction and display in cine mode, and com- plete CT perfusion imaging were performed simultaneously. Results： We succeeded in obtaining plain images of whole-brain, dynamic CTA and whole-brain perfusion images in 18 patients, all of which showed lesions of stenosis and obstruction in in- ternal carotid artery （ICA）, proximum of Willis circle and posterior and middle cerebral arteries; abnormal vessel network in the basal part of brain; and the condition of collateral circulation in the brain. Perfusion weighted imaging revealed mean transit time（MTT） was extended（0.5-13s）. Ten cases showed decrease in regional cerebral blood flow（rCBF）, the amplitude was 26.0%- 54.5%. There were 8 cases of normal and 4 cases decreased in regional cerebral blood volume（rCBV）. Conclusion： Whole brain dynamic volume imaging with 320-detector row CT can provide 3D structure of vessels of the whole brain, and serial of the dynamic blood flow and cerebral perfusion in a single scanning, which has the potential diagnostic value in moyamoya disease.

关 键 词：脑底异常血管网病 体层摄影术 螺旋计算机 血管造影术 

分 类 号：R743.4[医药卫生—神经病学与精神病学] R814.42[医药卫生—临床医学]