脑血流灌注成像在脑血管搭桥术前术后的评价比较分析  

Comparative analysis on the effect of Brain perfusion imaging in cerebral vascular bypass surgery during preoperation and postoperation

作　　者：王明盛[1] 周国胜[1] 周文科[1] 张新中[1] 

机构地区：[1]新乡医学院第一附属医院神经外科,河南新乡453100

出　　处：《现代预防医学》2012年第12期3144-3145,共2页Modern Preventive Medicine

摘　　要：目的探讨CT脑血流灌注成像在评价脑血管搭桥术前术后脑血流动力学变化中的作用。方法采用CT灌注成像技术对接受脑血管搭桥术治疗的缺血性脑血管病患者手术前后的CT灌注成像(CTperfusion,CTP)灌注参数进行了对比研究,了解手术前后患者脑血流动力学的改善情况,以探讨CT脑血流灌注成像在评价脑血管搭桥术前术后脑血流动力学变化中的作用。结果对本组28例缺血性脑血管病患者的狭窄血管供血区术前、术后相对灌注值进行比较发现搭桥术后狭窄血管供血区的rTTP值较术前明显降低,且差异有统计学意义(t=3.98,P﹤0.05)。而rCBF、rCBV在搭桥术前、术后则无明显变化(t=0.38、0.11,P均﹥0.05)。对本组28例缺血性脑血管病患者的狭窄血管非供血区术前、术后相对灌注值进行比较发现搭桥术后狭窄血管非供血区的rCBF、rCBV、rTTP值与搭桥术前比较均无明显变化(t=1.83、1.12、1.71,P均﹥0.05)。结论 CTP方法可成为脑血管搭桥术后脑血流动力学改变的无创性监测方法,尤其其中rTTP可作为反映血管搭桥术血流动力学变化的敏感指标。OBJECTIVE To explore the cerebral hemodynamic changes of CT brain perfusion imaging in the evaluation of cerebral vascular bypass surgery. METHODS CT perfusion imaging was used for cerebral vascular bypass surgery in treatment of ischemic cerebral vascular disease patients before and after operation （CT perfusion, CTP）, and we compared the perfusion parameters before and after the operation, understood the cerebral hemodynamics in patients to improve the situation, and explored the CT brain perfusion imaging to evaluate the cerebral hemodynamic changes before and after cerebral vascular bypass preoperation. RESULTS The rTTP value of ischemic cerebral vascular disease vascular supply area of 28 cases before and after operation were significant reduced when compared with bypass postoperative stenosis vascular blood supply region （t = 3.98, P ﹤0.05）. While the rCBF and rCBV did not show significant difference before and after bypass operation （t = 0.38, 0.11, P﹥ 0.05）. The rCBF, rCBV and rTTP of group of stenosis of vascular non supply area of 28 patients with ischemic cerebrovascular disease before and after operation showed significant difference with those of stenosis vascular non blood supply region before opeartion （t = 1.83, 1.12, 1.71, P﹥0.05）. CONCLUSION CTP method can become a brain vascular bypass cerebral hemodynamic changes after noninvasive monitoring method, and the rTTP can represent vascular bypass hemodynamic changes in the sensitive index.

关 键 词：脑血流 灌注成像 脑血管搭桥术 

分 类 号：R651.12[医药卫生—外科学]