头颈CTA联合全脑CT灌注扫描对缺血性脑卒中侧支循环的评估价值  

The value of head and neck CTA combined with whole brain CT perfusion scan in the assessment of collateral circulation in ischemic stroke

作　　者：王姿丽 WANG Zi-li(Bayannur Hospital,Bayannur 015000,China)

机构地区：[1]巴彦淖尔市医院,015000

出　　处：《中国实用医药》2023年第3期71-74,共4页China Practical Medicine

摘　　要：目的研究缺血性脑卒中侧支循环运用头颈CT血管成像(CTA)联合全脑CT灌注扫描的评估价值。方法50例缺血性脑卒中患者,均接受头颈CTA联合全脑CT灌注扫描,按照检查结果分为侧支循环良好组和侧支循环不良组,各25例。比较两组梗死灶个数以及梗死区、半暗带区的脑血流动力学参数[脑血容量(CBV)、对比剂峰值时间(TTP)、平均通过时间(MTT)、脑血流量(CBF)]。结果侧支循环不良组梗死区和半暗带区CBV、TTP、MTT、CBF分别为(0.82±0.33)ml/100 g、(26.02±6.45)s、(10.23±0.85)s、(7.62±1.35)ml/(100 g·min)和(1.57±0.51)ml/100 g、(17.97±3.20)s、(5.47±1.22)s、(18.56±5.03)ml/(100 g·min),梗死灶个数为(28.00±8.10)个;侧支循环良好组梗死区和半暗带区CBV、TTP、MTT、CBF分别为(1.02±0.26)ml/100 g、(23.30±1.46)s、(7.14±0.28)s、(16.48±3.19)ml/(100 g·min)和(2.29±0.59)ml/100 g、(10.53±3.06)s、(3.80±1.02)s、(27.59±5.63)ml/(100 g·min),梗死灶个数为(15.00±8.05)个。侧支循环不良组梗死区和半暗带区CBV、CBF均低于侧支循环良好组,TTP、MTT均高于侧支循环良好组,差异具有统计学意义(P<0.05);侧支循环不良组梗死灶个数多于侧支循环良好组,差异有统计学意义(P<0.05)。结论对缺血性脑卒中患者运用头颈CTA联合全脑CT灌注扫描,可以帮助医务人员评估侧支循环情况,具有较好的预后判断价值。Objective To study the value of head and neck angiography(CTA)combined with whole brain CT perfusion scan in the assessment of collateral circulation in ischemic stroke.Methods 50 patients with ischemic stroke underwent head and neck CTA combined with whole brain CT perfusion scans,and were divided into good collateral circulation group and poor collateral circulation group according to the examination results,with 25 patients in each group.The number of infarct foci cerebral hemodynamic parameters[cerebral blood volume(CBV),time to peak(TTP),mean transit time(MTT),and cerebral blood flow(CBF)]of the infarcted area,and penumbra area were compared between the two groups.Results In the poor collateral circulation group,the CBV,TTP,MTT,CBF in the infarcted area and penumbra area were(0.82±0.33)ml/100 g,(26.02±6.45)s,(10.23±0.85)s,(7.62±1.35)ml/(100 g·min),and(1.57±0.51)ml/100 g,(17.97±3.20)s,(5.47±1.22)s,(18.56±5.03)ml/(100 g·min)respectively,and the number of infarct foci was(28.00±8.10)foci.In the good collateral circulation group,the CBV,TTP,MTT,CBF in the infarcted area and penumbra area were(1.02±0.26)ml/100 g,(23.30±1.46)s,(7.14±0.28)s,(16.48±3.19)ml/(100 g·min),and(2.29±0.59)ml/100 g,(10.53±3.06)s,(3.80±1.02)s,(27.59±5.63)ml/(100 g·min)respectively,and the number of infarct foci was(15.00±8.05)foci.The CBV and CBF in infarct area and penumbra area of the poor collateral circulation group were lower than those of the good collateral circulation group,and the TTP and MTT were higher than those of the good collateral circulation group.The differences were statistically significant(P<0.05).The infarcted focus in the poor collateral circulation group was more than that in the good collateral circulation group,and the difference was statistically significant(P<0.05).Conclusion The use of head and neck CTA combined with whole brain CT perfusion scan in patients with ischemic stroke can help medical staff to evaluate collateral circulation,and has a good prognostic value.

关 键 词：头颈CT血管成像 全脑CT灌注扫描 缺血性脑卒中 侧支循环 

分 类 号：R743.3[医药卫生—神经病学与精神病学]