脑小血管病性痴呆与卒中后痴呆脑血流CT灌注差异的初步研究  

Preliminary study on the difference of cerebral blood flow CT perfusion between patients with cerebral small vessel dementia and post-stroke dementia

作　　者：倪健坤 赵雪文 计一丁 厉青[2] 刘利[1] 叶秋芸 NI Jiankun;ZHAO Xuewen;JI Yiding;LI Qing;LIU Li;YE Qiuyun(Department of Medical Imaging,Suzhou Ninth Hospital Affiliated to Soochow University,Suzhou 215200,Jiangsu,China;Department of Neurology,Suzhou Ninth Hospital Affiliated to Soochow University,Suzhou 215200,Jiangsu,China)

机构地区：[1]苏州大学附属苏州九院影像科,江苏苏州215200 [2]苏州大学附属苏州九院神经内科,江苏苏州215200

出　　处：《右江医学》2022年第10期750-754,共5页Chinese Youjiang Medical Journal

基　　金：苏州大学附属苏州九院资助课题(院201837号)。

摘　　要：目的探讨脑小血管病性痴呆与卒中后痴呆脑血流CT灌注的差异。方法应用西门子双源CT对脑小血管病性痴呆30例,卒中后痴呆25例行颅脑CT灌注检查,所有患者用MMSE和MoCA量表进行认知功能评估,使用西门子MMWP工作站后处理软件分别测量额叶皮质、额叶白质、颞叶皮质、颞叶白质的血流量(CBF)、血容量(CBV)、平均通过时间(MTT),并取年龄、性别及身体状况与患病组相仿的30例志愿者为对照组,分析脑小血管病性痴呆与卒中后痴呆的脑血流灌注特点及差异。结果脑小血管病性痴呆患者额叶皮质及白质CBF、CBV与对照组及卒中后痴呆组比较差异均有统计学意义(P<0.05),脑小血管病性痴呆额、颞叶白质MTT较对照组及卒中后痴呆组明显延长(P<0.05)。卒中后痴呆额颞叶皮质及白质CBF、CBV、MTT与对照组比较差异均无统计学意义(P>0.05)。结论脑小血管病性痴呆与卒中后痴呆脑血流灌注特点并不相同,额叶皮质、白质的脑灌注下降为脑小血管病性痴呆的特有表现。Objective To investigate the difference of cerebral blood flow CT perfusion between cerebral small vessel dementia and post-stroke dementia.Methods 30 cases of cerebral small vessel dementia and 25 cases of post-stroke dementia were examined through craniocerebral CT perfusion by using Siemens dual-source CT.The cognitive function of all patients was evaluated with MMSE and MoCA,and the cerebral blood flow(CBF),cerebral blood volume(CBV)and its mean transit time(MTT)in frontal cortex,frontal white matter,temporal cortex and temporal white matter were measured by Siemens Multimodality Workplace(MMWP)post-processing.30 volunteers with similar age,gender,and physical condition selected as the control group were used to comparatively analyze the characteristics and differences of cerebral blood flow perfusion between small vessel dementia and post-stroke dementia.Results The CBF and CBV in frontal cortex and white matter of patients with cerebral small vessel dementia were statistically significantly different from those of control group and post stroke dementia group(P<0.05).The MTT in frontal and temporal lobe white matter of patients with cerebral small vessel dementia was significantly longer than those of the control group and the post-stroke dementia group(P<0.05).There was no statistically significant difference in CBF,CBV and MTT in frontotemporal cortex and white matter between the post-stroke dementia group and the control group(P>0.05).Conclusion The characteristics of cerebral blood flow perfusion in patients with cerebral small vessel dementia are different from that in patients with post-stroke dementia,and the decrease of cerebral perfusion in frontal cortex and white matter is the unique manifestation of cerebral small vessel dementia.

关 键 词：脑小血管病 痴呆 卒中后痴呆 CT灌注 

分 类 号：R749.1[医药卫生—神经病学与精神病学]