椎动脉狭窄支架成型手术前后CT灌注影像研究  

CT perfusion imaging before and after vertebral artery stenosis stenting

作　　者：金点石[1] 宋憧 王淑艳 冷晓磊[1] 魏伟[1] 李旭琴[1] Jin Dianshi;Song Chong;Wang Shuyan;Leng Xiaolei;Wei Wei;Li Xuqin(Department of Neurosurgery, Affiliated Center Hospital, Dalian Medical University, Dalian, Liaoning 116033, China)

机构地区：[1]大连医科大学附属中心医院神经外科

出　　处：《中国微侵袭神经外科杂志》2019年第7期295-298,共4页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：大连市卫计委基金(编号:201618)

摘　　要：目的探讨椎动脉狭窄支架成型手术前后的CT灌注成像(CT perfusion,CTP)的影像学特点,为术前评估及术后评价提供诊断依据。方法回顾性分析50例椎动脉狭窄支架手术病人的临床资料,手术前后行CTP及CT血管成像(CT angiography,CTA)及全脑血管造影(digital substraction angiography,DSA)。检测病侧与健侧的平均通过时间(mean transmit time,MTT)、脑血流量(cerebral blood flow,CBF)、脑血容量(cerebral blood volume,CBV)并进行统计分析,同时对比病侧手术前后的影像特点。结果 50例病人术后狭窄均解除,无严重并发症。术前CTP发现35例灌注异常,阳性率70%;其中病侧与健侧CBF、MTT比较差异具有统计学意义(P <0.05)。其中31例(88.6%)术后病侧CTP较术前改善,手术前后CBF、MTT比较差异具有统计学意义(P <0.05);余4例无变化。结论 CTP较为敏感,可以反映后循环脑组织的缺血灌注状态,也可以用于椎动脉支架成型手术的术前评估、术后评价。Objective To explore the application of CT perfusion(CTP) imaging before and after vertebral artery stennosis stenting in order to provide the evidence for preoperative and postoperative evaluation. Metheods Clinical data of 50 patients with vertebral artery stenosis who underwent endovascular stenting were analyzed retrospectively. CTP, CT angiography( CTA) and digital substraction angiography(DSA) were performed before and after surgery. The mean transmit time(MTT),cerebral blood flow(CBF)and cerebral blood volume(CBV) between the affected and unaffected sides of the patients were analyzed statistically, and the imaging results of the affected sides before and after surgery were compared. Results The stenosis of 50 patients was removed after the surgery and there were no severe complications. The abnormal perfusion was observed in 35 patients(70%). The differences in CBF and MTT between the affected and unaffected sides were statistically significant( P < 0.05). Compared with the preoperative imaging, the postoperative CTP imagings were improved in 31 patients(88.6%) of 35 patients. The differences in CBF and MTT between the data before and after surgery were statistically significant(P < 0.05). There was no improvement in the remaining 4. Conclusion CTP is sensitive to reflect the perfusion of posterior cerebral circulation and can be also used as an evaluation method before and after the surgey.

关 键 词：椎动脉狭窄 支架 CT灌注影像 

分 类 号：R743[医药卫生—神经病学与精神病学] R651.12[医药卫生—临床医学]