三磷腺苷负荷脑血流灌注显像对后循环缺血病变的评估价值  

The value of adenosine triphosphate stress cerebral blood flow imaging in the assessment of posterior circulation ischemia

作　　者：刘杰[1] 刘蕾[2] 金超岭 郑玉民[1] 尹立杰[1] LIU Jie;LIU Lei;JIN Chao-ling(Department of Nuclear Medicine,China-Japan Friendship Hospital,Beijing 100029,China)

机构地区：[1]中日友好医院核医学科,北京100029 [2]中日友好医院神经内科,北京100029

出　　处：《中日友好医院学报》2021年第5期265-267,272,F0004,共5页Journal of China-Japan Friendship Hospital

基　　金：中日友好医院院级课题(2015-1-QN-26)。

摘　　要：目的:探讨三磷腺苷(ATP)负荷对后循环缺血(PCI)病变脑血流灌注改变及脑血管储备能力的评估价值。方法:前瞻性纳入2017年5月~2019年9月间于中日友好医院就诊的PCI患者26例,其中男20例、女6例;年龄56~79岁,平均62±10.3岁。患者采用两日法进行静息及负荷脑血流灌注显像,勾画并计算18个脑区局部脑血流灌注量以及评判负荷前后脑血流灌注变化情况。结果:26例PCI患者经数字减影血管造影(DSA)检查提示单支后循环血管病变者10例,双侧后循环血管病变11例,前循环+后循环血管病变5例。基底动脉狭窄者以卒中居多。单支血管病变患者患侧负荷相局部脑血流量(rCBF)与静息相无显著性差异(P=0.088)。多支血管病变(双侧后循环或前循环+后循环)患者静息相rCBF为(69.1±11.6)ml/(100g·min),显著高于负荷相rCBF[(58.7±12.2)ml/(100g·min),P<0.01]。26例患者共18例出现rCBF下降,以多支血管病变或前循环加后循环血管病变患者居多(83.3%)。结论:ATP负荷脑血流灌注显像可帮助了解患者脑血流灌注及储备情况,为尽早治疗PCI提供依据。Objective:To explore the value of adenosine triphosphate(ATP)stress in the assessment of cerebral blood flow perfusion and cerebrovascular reserve capacity in patients with posterior circulatory ischemia(PCI).Methods:A total of 26 PCI patients,aged 56 ~79 years,were enrolled prospectively patients of China-Japan Friendship Hospital from May 2017 to Sep.2019.They underwent two-day rest and stress cerebral blood flow imaging.The regional cerebral blood flow(r CBF)of 18 brain regions were plotted and calculated.Results:DSA of26 PCI patients showed that there were 10 cases of single posterior circulation vessel disease,11 cases of bilateral posterior circulation vessel disease,5 cases of anterior circulation plus posterior circulation vessel disease.Stroke was the most common manifestation in patients with basilar artery stenosis.There was no statistically significant between the rest and stress rCBF in single posterior circulation vascular disease(t =1.714,P =0.088).The rest r CBFs of patients with multivessel disease was(69.1±11.6)ml/(100 g·min),higher than that of stress imges[(58.7±12.2)ml/(100 g·min),t=26.5,P<0.01].There were 18 out of 26 cases whose rCBF decreased.Most of them had multivessel disease or precirculation plus postcirculation vascular disease(83.3%,15/18).Conclusion:ATP loaded cerebral blood flow perfusion imaging can help to understand the cerebral blood flow perfusion and reserve of the patients, provide basis for early treatment of PCI.

关 键 词：后循环缺血 局部脑血流量 三磷腺苷 

分 类 号：R445.5[医药卫生—影像医学与核医学]