侧支循环在评估急性前循环脑梗死范围中的应用研究  

Application of collateral circulation in the evaluation of the extent of acute anterior circulation cerebral infarction

作　　者：陈鹏飞 史河水[2] 梁奕 范文辉 杜柏林 李贞 CHEN Pengfei;SHI Heshui;LIANG Yi;FAN Wenhui;DU Bolin;LI Zhen(Departmentof Radiology,General Hospital of the Yangtze River Shipping,Wuhan 430010,China;Departmentof Radiology,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430022,China)

机构地区：[1]长江航运总医院医学影像科,湖北武汉430010 [2]华中科技大学同济医学院附属协和医院放射科,湖北武汉430022

出　　处：《实用放射学杂志》2022年第5期712-716,共5页Journal of Practical Radiology

摘　　要：目的探讨侧支循环在评估急性前循环脑梗死范围中的价值。方法选取63例急性前循环大血管闭塞脑梗死患者,对CT平扫及CT灌注成像(CTP)图像进行Alberta卒中项目早期CT评分(ASPECTS),同时进行动态CT血管成像(CTA)侧支循环评分,最终梗死范围在患者入院30~90 d CT复查时获得,分别以脑血容量(CBV)-ASPECTS、最终梗死范围ASPECTS为因变量进行多元线性回归分析。结果动态CTA侧支循环评分(P=0.000)及美国国立卫生研究院卒中量表(NIHSS)评分(P=0.01)是CBV-ASPECTS的独立危险因素,动态CTA侧支循环评分(P=0.000)及脑血流量(CBF)-ASPECTS(P=0.000)是最终梗死范围ASPECTS的独立危险因素。结论良好的侧支循环及较小的NIHSS评分提示基线核心梗死区越小,通过动态CTA侧支循环评分及CBF-ASPECTS可以预测最终梗死区范围。Objective To investigate the value of collateral circulation in the evaluation of the extent of acute anterior circulation cerebral infarction.Methods Sixty-three patients with acute anterior circulation large vessel occlusion cerebral infarction were included.Alberta Stroke Program Early CT Score(ASPECTS)were performed on CT plain scan and CT perfusion(CTP)images and dynamic CT angiography(CTA)collateral circulation score were acquired.The final infarct area was obtained by CT reexamination from 30 to 90 days after admission.Multiple linear regression analysis was performed with cerebral blood volume(CBV)-ASPECTS and final infarct area ASPECTS as dependent variables.Results Dynamic CTA collateral circulation score(P=0.000)and National Institutes of Health Stroke Scale(NIHSS)(P=0.01)were independent risk factors for the CBV-ASPECTS.The dynamic CTA collateral circulation score(P=0.000)and cerebral blood flow(CBF)-ASPECTS(P=0.000)were independent risk factors for the final infarct area ASPECTS.Conclusion Good collateral circulation and small NIHSS mean that the baseline core infarct area may be smaller,and the final infarct area can be predicted by dynamic CTA collateral circulation score and CBF-ASPECTS.

关 键 词：侧支循环 核心梗死区 最终梗死区 计算机体层成像 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R814.42[医药卫生—临床医学]