合并同侧颈内动脉海绵窦段狭窄的颈动脉内膜切除术后脑灌注改变  

The changes of CT perfusion after carotid endarterectomy in patients with carotid stenosis complicated by ipsilateral moderate stenosis of carotid cavernous sinus

作　　者：韩枫[1] 许灿[2] 陈超旭 王翠 张建霞 王元朔 郑军[4] 孙晓枫[4] HAN Feng;XU Can;CHEN Chaoxu(Department of Neurosurgery,The Second Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050000,China;不详)

机构地区：[1]河北省石家庄市第二医院神经外科,050000 [2]河北省石家庄市第二医院放射科,050000 [3]河北医科大学第二医院放射科 [4]河北医科大学第二医院神经外科 [5]河北省大城县中医院放射科

出　　处：《河北医药》2022年第16期2447-2450,共4页Hebei Medical Journal

基　　金：河北省卫生和计划生育委员会科研基金项目(编号:20191414)。

摘　　要：目的探讨颈动脉内膜切除术(carotid endarterectomy,CEA)对合并同侧颈内动脉海绵窦段中度狭窄的症状性重度颈动脉狭窄患者是否带来更多益处。方法选取2018年6月至2020年1月接受治疗的CEA患者52例,依据术前CT血管造影检查(CT angiography,CTA)是否存在同侧颈内动脉海绵窦段中度狭窄分为狭窄组(40例)和无明显狭窄组(12例)。2组患者均于术前1周、术后1月分别行头颅CT灌注成像(CT perfusion imaging,CTP)检查。手动选取感兴趣区(region of interest,ROI),将各ROI(患侧)与对称位置(健侧)的平均通过时间(mean transit time,MTT)、达峰时间(time to peak,TTP)、脑血流量(cerebral blood flow,CBF)、脑血容量(cerebral blood volume,CBV)的差率分别进行术前术后比较。从而统计出四格表资料,得出结果。结果无明显狭窄组MTT、TTP、CBF、CBV术前术后差率与狭窄组MTT、TTP、CBF、CBV术前术后差率的差异无统计学意义(P>0.05)。结论合并同侧颈内动脉海绵窦段中度狭窄的症状性重度颈动脉狭窄患者,仍可从CEA手术中获得更多益处,建议手术。Objective To investigate the clinical effects of carotid endarterectomy(CEA)in patients with carotid stenosis complicated by ipsilateral moderate stenosis of carotid cavernous sinus.Methods A total of 52 patients who were treated by CEA in our hospital fron June 2018 to January 2020 were enrolled in the study.Acording to the results of CT angiography(CTA),these patients were divided into stenosis group(n=40)and non-stenosis group(n=12).The cerebral CT perfusion imaging(CTP)was performed at 1w before operation and 1m after operation in both groups.The regions of interest(ROI)was chosen manually,then the differences of mean transit time(MTT),time to peak(TTP),cerebral blood flow(CBF),cerebral blood volume(CBV)before operation and after operation were observed and compared between the two groups.Results There were no significant differences in the results of MTT,TTP,CBF,CBV before operation and after operation between stenosis group and non-stenosis group(P>0.05).Conclusion CEA can bring more benefits for patients with carotid stenosis complicated by ipsilateral moderate stenosis of carotid cavernous sinus,and surgery is recommended.

关 键 词：颈动脉内膜切除术 CT灌注成像 颅内动脉狭窄 

分 类 号：R543.5[医药卫生—心血管疾病]