脑梗死前期CT灌注成像异常与血管狭窄的关系  

The correlation between abnormal CT perfusion in the early period of cerebral infarction and angiostenosis

作　　者：邱晓晖[1] 章辉庆[1] 刘艺超[1] 董修明[1] 郏立志[1] 穆玲[1] 

机构地区：[1]安徽省亳州市人民医院影像中心,236803

出　　处：《蚌埠医学院学报》2013年第12期1645-1648,共4页Journal of Bengbu Medical College

基　　金：安徽省亳州市科研基金创新资助项目(A2011002)

摘　　要：目的:探讨短暂性脑缺血发作(transient ischemic attack,TIA)患者在脑梗死前期CT灌注成像(CTP)异常与血管狭窄之间的关系,并分析血管表面通透性(PS)的变化。方法:经临床确诊的TIA患者56例,利用128层螺旋CT机,先行CT及MRI平扫,排除脑出血及急性期脑梗死,然后再行全脑CTP及CT血管成像(CTA)检查。对CTP异常者,按照灌注分期标准分为Ⅰ期、Ⅱ期;按CTA结果分为血管轻度狭窄组和血管中重度狭窄组。结果:CT灌注异常者56例,其中Ⅰ期39例,Ⅱ期17例。CTA表现为:血管轻度狭窄11例,中重度狭窄26例。血管轻度狭窄组与中重度狭窄组间异常灌注分期差异有统计学意义(P<0.01)。Ⅰ、Ⅱ期患者患侧PS值均较健侧延长(P<0.01);Ⅰ、Ⅱ期患者间脑健侧和患侧PS值差异均无统计学意义(P>0.05)。结论:TIA患者CTP异常与血管狭窄程度有关。通过CTP与CTA检查,并结合其他临床体征,可以对TIA患者的预后进行评估,从而指导临床进行干预性治疗。Objective：To explore the correlation between abnormal CT perfusion （CTP） in the early period of cerebral infarction in patients with transient ischemic attack （TIA） and angiostenosis, and analyse the change of permeability surface （PS）. Methods：The CTP and CT angiography （CTA） in 56 patients with TIA were implemented using 128 layers spiral CT machine when cerebral hemorrhage and acute cerebral infarction were ruled out by CT and MRI scanning. The patients with abnormal CT P were divided into stage Ⅰ and Ⅱ according to perfusion stage, and mild and moderately severe angiostenosis group according to CTA. Results ： Amony 56 patients with abnormal cerebral perfusion, stage Ⅰ in 39 cases and stage Ⅱ in 11 cases were found. According to CTA, mild angiostenosis in 11 cases and moderately severe angiostenosis in 26 cases were found. The difference of perfusion stage between mild and moderately severe angiostenosis group was statistically significant（P 〈 0.01 ）. The value of PS in lesion side was longer than that in contralateral side in patients with stage Ⅰ and Ⅱ （P 〈 0.01 ） ,there was not significant difference between lesions and contralateral side of brain PS in patients with stage Ⅰ and Ⅱ （P 〉 0.05）. Conclusions ： Abnormal cerebral perfusion in patients with TIA is related with the degree of angiostenosis. The patient prognosis can be evaluated by CTP, CTA combined with clinical sign, which can guide the preventive treatmen.

关 键 词：短暂性脑缺血发作 体层摄影术 X线计算机 灌注 脑血管狭窄 

分 类 号：R816.1[医药卫生—放射医学]