脑灌注量与脑白质疏松症的相关性研究  

Research on the correlation between cerebral perfusion volume and leukoaraiosis

作　　者：钟莉莉 冯占辉 杨雪霞 吴珊 楚兰 倪睿涵 陈连花 王波 ZHONG Lili;FENG Zhanhui;YANG Xuexia(Department of Neurology/Imaging Department,Affiliated Hospital of Guizhou Medical Universiy,Guiyang(550004),Guizhou,China)

机构地区：[1]贵州医科大学附属医院神经内科,贵州贵阳550004

出　　处：《癫痫与神经电生理学杂志》2019年第2期91-95,共5页Journal of Epileptology and Electroneurophysiology(China)

基　　金：国家重点研发计划基金项目(NO:2018YFC1312901);贵州省卫生厅科学技术基金项目(NO:gzwkj2013-1-D10);2017年度贵州省高层次创新型人才项目。

摘　　要：目的:对不同分级的脑白质疏松症(leukoaraiosis.LA)患者行脑CT灌注成像(computed tomography perfusion,CTP),探讨脑灌注量与LA严重程度的相关性。方法:选取2017年10月至2018年10月在贵州医科大学附属医院行头颅MRI检査并诊断为LA的107例患者,根据Fazekas分级标准,分为LA1级组(50例).LA2级组(41例)及LA3级组(16例);均行脑CT灌注成像检査.测量半卵圆中心、侧脑室旁、基底节区3个层面的平均脑血流量(CBF)、脑血容量(CBV)值;分別定义为CBF1、2、3,CBV1、2、3,分析不同程度LA患者脑灌注量之间的差异性。结果:①3组LA患者间年龄存在差异.年龄与CBF1XBF2有相关性(P<0.05);②三组LA患者间CBF在半卵圆中心层面(P=0.002)、侧脑室旁层面(P=0.005)有差异;CBV在半卵圆中心层面(P=0.006)、侧脑室旁层面(P=0.002)有差异;两两比较提示LA1级组和LA2级组CBF在半卵圆中心层面(P=0.007),侧脑室旁层面(P=0.012)有差异;CBV在半卵圆中心层面(P=0.024)、侧脑室旁层面(P=0.009)有差异;③107例患者半卵圆中心层面、侧脑室旁层面、基底节区层面的CBF逐渐升高(P=0.000)。结论:LA患者半卵圆中心层面、侧脑室旁层面的CBF及CBV随着严重程度的升高而降低。半卵圆中心层面、侧脑室旁层面、基底节区层面的CBF逐渐升高=LA严重程度随年龄增加而增加。Objective: Cerebral CT perfusion imaging was performed in patients with different grades of leukoaraiosis (LA) to explore the correlation between cerebral perfusion volume and the severity of LA, Methods: 107 patients with LA diagnosed by cranial MRI in our hospital from October 2017 to October 2018 were divided into LAI group (50 cases), LA2 group (41 cases) and LA3 group (16 cases) according to Fazekas classification criteria, All patients were examined by computed tomography perfusion (CTP), and the average perfusion volume was measured at three layers: the center of semiovale, the paraventricle of lateral ventricle and the basal ganglia, The differences of cerebral blood flow (CBF) and cerebral blood volume (CBV) were compared and analyzed in different grades of LA, They were defined as CBF1,2,3/ CBV1 ,2, 3. At the same time, the differences of triglycerides, total cholesterol and homocysteine among the three groups were compared, Result: 1) There were age differences among the three groups, and age was correlated with CBF1 and CBF2 (P<0.05). 2)There were differences in CBF at the central level of semiovale ( P = 0.002) and paraventricular level (P = 0.005) among the three groups: CBV at the central level of semiovale ( P = 0.006) and paraventricular level ( P = 0.002);the two comparisons suggested that CBF at the central level of semiovale ( P =0.007) and paraventricular level (P = 0.012) were different between LAI and LA2 groups;CBV at the central level of semiovale (P = 0.024) and paraventricular layer (P = 0.009) were different between LAI and LA2 groups, 3) Cerebral blood flow increased gradually in 107 cases at the level of semioval center, paraveniricular side and basal ganglia ( P = 0.000), Conclusion: Cerebral blood flow (CBF) and cerebral blood volume (CBV) in the central senlioval and paraventricular layers of patients with LA decreased with the increase of its severity, The cerebral blood flow increased gradually in the central layer of semioval, paraventricular layer and basal ganglia layer, LA s

关 键 词：脑白质疏松症(LA) 脑CT灌注成像(CTP) 脑灌注参数 脑血流量(CBF) 脑血容量(CBV) 

分 类 号：R743[医药卫生—神经病学与精神病学]