脑小血管病影像学和CT灌注成像特征与颅内大血管狭窄介入术后脑过度灌注综合征的关系  

Relationship Between the Imaging and CT Perfusion Imaging Characteristics of Small Cerebral Vascular Disease and Cerebral Hyperperfusion Syndrome After Intracerebral and Extracranial Great Vessels Stenosis Intervention

作　　者：秦晋辉 程相杰[1] 朱星阳 王晓丽[1] 宋元贞 胡义平[1] 张青 赵茜 QIN Jinhui;CHENG Xiangjie;ZHU Xingyang;WANG Xiaoli;SONG Yuanzhen;HU Yiping;ZHANG Qing;ZHAO Qian(Nanyang Second People’s Hospital,Nanyang 473000,China)

机构地区：[1]南阳市第二人民医院,河南南阳473000

出　　处：《河南医学研究》2024年第1期81-85,共5页Henan Medical Research

基　　金：南阳市科技攻关计划项目(KJGG019)。

摘　　要：目的探讨脑小血管影像学和CT灌注成像(CTP)特征与颅内大血管狭窄介入术后脑过度灌注综合征的关系。方法选取2021年1月至2023年2月在南阳市第二人民医院行颅内大血管狭窄介入术后脑过度灌注综合征患者35例作为观察组,同时选取颅内大血管狭窄介入术后未发生脑过度灌注综合征患者106例作为对照组,比较两组术前脑小血管病影像学和CTP特征差异,分析脑小血管病影像学和CTP特征预测术后脑过度灌注综合征发生的价值。结果观察组存在腔隙、脑白质高信号(WMH)比例分别为91.43%和100.00%,高于对照组(P<0.05);观察组腔隙个数、Fazekas评分和脑小血管病影像(CSVD)总负荷评分分别为4(2,6)个、3(2,4)分和3(2,4)分,高于对照组(P<0.05);观察组相对血流通过实践(rMTT)和相对对比剂达峰时间(rTTP)分别为(1.26±0.13)和(1.20±0.14),高于对照组(P<0.05);脑小血管病影像参数有腔隙、WMH、腔隙个数、Faezkas评分、CSVD总负荷评分预测术后脑过度灌注综合征的ROC曲线下面积分别为0.665、0.661、0.986、0.903和0.901,其中腔隙个数预测价值最高;CTP参数rMTT和rTTP预测术后脑过度灌注综合征的ROC曲线下面积分别为0.905和0.823,其中rMTT预测价值最高。结论术前脑小血管病影像学和CTP特征预测颅内大血管狭窄介入术后脑过度灌注综合征有较好的应用价值,其中脑小血管病影像学参数腔隙个数、CTP参数rMTT预测术后脑过度灌注综合征价值较高。Objective To explore the relationship between the characteristics of small cerebral vessels imaging and CT perfusion imaging(CTP)and cerebral hyperperfusion syndrome after interventional treatment of intracranial and extracranial great vessels stenosis.Methods From January 2021 to February 2023,35 patients with cerebral hyperperfusion syndrome after extracranial and extracranial great vessels stenosis intervention in Nanyang Second People’s Hospital were selected as the observation group,and 106 patients without cerebral hyperperfusion syndrome after extracranial and extracranial great vessels stenosis intervention were selected as the control group.The differences in imaging and CTP features of preoperative cerebral small vessel disease between two groups were compared,and the value of imaging of cerebral small vessel disease and CTP features in predicting the occurrence of postoperative cerebral hyperperfusion syndrome were analyzed.Results The proportion of lacunae and white matter hyperintensities(WMH)in the observation group was 91.43% and 100.00%,respectively,which was higher than that in the control group(P<0.05).The number of lacunae,Fazekas score,and total load score of cerebrovascular disease imaging(CSVD)in the observation group were 4(2,6),3(2,4),and 3(2,4),respectively,which were higher than those in the control group(P<0.05).The relative mean transit time(rMTT)and relative time to peak(rTTP)of the observation group were(1.26±0.13)and(1.20±0.14),respectively,which was higher than the control group(P<0.05).The area under ROC of imaging parameters of small cerebral vascular disease include lacunae,WMH,number of lacunae,Faezkas score,and CSVD total load score to predict cerebral hyperperfusion syndrome after surgery were 0.665,0.661,0.986,0.903,and 0.901,the highest predictive value for the number of cavities.The area under ROC of cerebral hyperperfusion syndrome after surgery predicted by the CTP parameters rMTT and rTTP was 0.905 and 0.823,respectively,of which rMTT had the highest predictive valu

关 键 词：脑小血管影像学 CT灌注成像 颅内大血管狭窄 脑过度灌注综合征 

分 类 号：R445[医药卫生—影像医学与核医学]