单侧颈内动脉或大脑中动脉狭窄患者脑灌注成像及与血管狭窄程度相关性初步研究  

PRELIMINARY STUDY ON CEREBRAL PERFUSION IMAGING OF PATIENTS WITH UNILATERAL IN-TERNAL CAROTID ARTERY OR MIDDLE CEREBRAL ARTERY STENOSIS AND ITS CORRELATION WTTH THE DEGREE OF STENOSIS

作　　者：李华莉[1] 罗敏[1] 姜萍[1] LI Huali;LUO Min;JIANG Ping(Zigong Fourth People's Hospital,Zigong 43000.China)

机构地区：[1]四川省自贡市第四人民医院,643000

出　　处：《中国煤炭工业医学杂志》2023年第3期290-293,共4页Chinese Journal of Coal Industry Medicine

基　　金：四川省卫生健康科研项目(编号:20PJ274)。

摘　　要：目的研究单侧颈内动脉(ICA)或大脑中动脉(MCA)狭窄患者脑灌注成像及与血管狭窄程度相关性。方法选取2020年8月—2022年8月该院确诊为单侧ICA/MCA中度以上狭窄患者74例作为观察组,将对侧颈内动脉系统无血管狭窄或仅存在轻度狭窄作为对照组,行颅脑CT灌注成像(CTP)及同步CT血管造影(CTA)检查,比较两组脑灌注成像参数[达峰时间(TTP)、平均通过时间(MTT)、脑血容量(CBV)、脑血流量(CBF)];并根据血管狭窄程度分为中度狭窄组(狭窄率50%~69%,n=35)、重度狭窄组(狭窄率70%~99%,n=23)和完全闭塞组(狭窄率100%,n=16),比较不同血管狭窄程度患者的TTP、MTT、CBV、CBF,采用Spearman相关性分析TTP、MTT、CBV、CBF与血管狭窄程度相关性。结果观察组MTT、TTP长于对照组,CBV、CBF低于对照组(P<0.05)。完全闭塞组单侧ICA/MCA狭窄患者MTT、TTP长于重度狭窄组和中度狭窄组,CBV、CBF低于重度狭窄组和中度狭窄组,重度狭窄组单侧ICA/MCA狭窄患者MTT、TTP长于中度狭窄组,CBV、CBF低于中度狭窄组(P<0.05)。Spearman相关性分析显示,MTT、TTP与血管狭窄程度呈正相关(r=0.443、0.435,P<0.05),CBV、CBF与血管狭窄程度呈负相关性(r=-0.419、-0.426,P<0.05)。结论单侧ICA/MCA狭窄患者存在相应供血区灌注不足,且狭窄程度越严重,脑血流量越低。Objective To study cerebral perfusion imaging of patients with unilateral internal carotid artery(ICA)or middle cerebral artery(MCA)stenosis,and its correlation with the degree of stenosis.Methods Seventy-four patients with moderate or more severe unilateral ICA/MCA stenosis diagnosed in the hospital from August 2020 to August 2022 were selected as the observation group.Patients without vascular stenosis in internal carotid artery system on the contralateral side or with mild stenosis were taken as the control group.All patients received brain CT perfusion(CTP)imaging and synchronous CT angiography(CTA).Brain perfusion imaging parameters[time to peak(TTP),mean transit time(MTT),cerebral blood volume(CBV)and cerebral blood flow(CBF)] were compared between groups.The subjects were divided into the moderate stenosis group(stenosis rate of 50%-69%,n=35),the severe stenosis group(stenosis rate of 70%-99%,n=23)and the total occlusion group(stenosis rate of 100%,n=16)according to the degree of vascular stenosis.TTP,MTT,CBV and CBF in patients with different degrees of vascular stenosis were comparatively analyzed.Spearman correlation analysis was performed to analyze the correlation between TTP,MTT,CBV,CBF and the degree of vascular stenosis.Results MTT and TTP in the observation group were longer than those in the control group.CBV and CBF were lower than those in the control group(P<0.05).MTT and TTP increased in order,while CBV and CBF decreased in order from the moderate stenosis group,the severe stenosis group to the total occlusion group(P<0.05).Spearman correlation analysis showed that MTT and TTP were positively correlated with the degree of vascular stenosis(r=0.443,0.435,P<0.05),while CBV and CBF were negatively correlated with the degree of vascular stenosis(r=-0.419,-0.426,P<0.05).Conclusion Patients with unilateral ICA/MCA stenosis have insufficient perfusion in the corresponding blood supply area.The more severe the stenosis,the lower the cerebral blood flow.

关 键 词：单侧颈内动脉狭窄 大脑中动脉狭窄 脑灌注成像 血管狭窄程度 

分 类 号：R543.5[医药卫生—心血管疾病]