短暂性脑缺血发作320排CT全脑灌注联合CT血管成像研究  

Clinical Significance in Transient Ischemic Attacks of 320-slice CT Perfusion Image in Combination with CT Angiography

作　　者：黄文琴[1] 黎红华[1] 陈信坚[1] 孙志强[1] 廖光昊[1] 邹佳妮[1] 

机构地区：[1]中国人民解放军广州军区武汉总医院神经内科,武汉430070

出　　处：《神经损伤与功能重建》2012年第6期429-432,共4页Neural Injury and Functional Reconstruction

摘　　要：目的:探讨320排CT在颈内动脉系统短暂性脑缺血发作(TIA)中的应用价值。方法:对颈内动脉系统TIA患者22例于发作间期进行320排CT全脑灌注成像(CTP)及头、颈部CT血管成像(CTA),观察颈内动脉系统颅内外血管状况及脑灌注情况。结果:17例(77.27%)患者存在血管病变;颅外血管狭窄以颈内动脉颅外段受累最多见(81.81%),颅内血管狭窄以大脑中动脉受累多见(61.11%);12例(54.55%)患者CTP图上发现与临床症状相对应的灌注异常区,其中Ⅰ1期2例,Ⅰ2期6例,Ⅱ1期3例,Ⅱ2期1例;灌注异常者患侧、对侧的平均达峰时间(TTP)分别为(16.64±2.04)s和(14.81±1.99)s(P<0.05),患侧、对侧的平均通过时间(MTT)分别为(4.45±0.74)s和(3.87±0.33)s(P<0.05);CTP异常与责任血管狭窄程度具有相关性,责任血管中、重度狭窄者CTP异常阳性率显著高于责任血管轻度狭窄者及无狭窄者(P<0.05)。结论:320排CT可对颈内动脉系统TIA患者血管状况及血流动力学进行有效评价。Objective： To assess the clinical value of 320-slice CT perfusions （CTP） image combining with CT angiography （CTA） in the intercranial artery system transient ishemic attack （TIA）. Methods： 320-slice whole-brain CTP, head and neck CTA were performed in 22 patients with anterior circulation system TIA. The intracranial and extracranial vasculars of the anterior circulation and the whole brain perfusions were observed. Results： Seventeen cases （77. 27%） presented vascular lesions. Extracranial carotid artery （81. 81%） and middle cerebral artery （61.11%） were most likely to suffer damage. Abnormal perfusions were found in 12 patients （54.55%）, in which 2 cases in Ⅱ stage, 6 cases in Ⅰ2 stage, 3 cases in Ⅲ stage and 1 case inⅡ2 stage. TTP was （16.64±2.04）s and （14.81±1.99）s and MTT was （4.45±0.74）s and （3.87±0.33）s in the ipsilateral and contralateral brain respectively in patients with abnormal perfusions. Significant differences both of the TTP and MTT were found in the ipsilateral and contralateral brain （P〈0.05）. Perfuion abnomralities were relative to the scope of vascular stenosis. Abnor- mal index of CTP was higher in patients with moderate/severe vascular stenosis than in those with mild/none vascular stenosis （P〈0.05）. Conclusion： It is effective to display the vessels and hemodynamie parameters of TIA in the anterior circulation system using 320-slice CT.

关 键 词：短暂性脑缺血发作 血管狭窄 320排CT CT血管成像 CT灌注成像 

分 类 号：R741[医药卫生—神经病学与精神病学] R743.31[医药卫生—临床医学]