成人烟雾病不同临床表现患者全脑CTP与CTA影像特征研究  

Study on imaging characteristics of whole brain CTP and CTA in adult patients with different clinical manifestations of moyamoya disease

作　　者：徐佳佳[1] 舒进鹏 陈晓荣[1] XU Jiajia;SHU Jinpeng;CHEN Xiaorong(Departmen of Medical Imaging,Affiliated Sinopharm Dongfeng General Hospital,Hubei University of Medicine,Shiyan,Hubei 442000,China)

机构地区：[1]湖北医药学院附属国药东风总医院医学影像部,湖北十堰442000

出　　处：《检验医学与临床》2024年第6期756-761,共6页Laboratory Medicine and Clinic

基　　金：湖北省十堰市引导性科研项目(22Y84)。

摘　　要：目的通过观察分析成人烟雾病的脑动脉CT血管成像(CTA)及全脑CT灌注成像(CTP)图像的特点,探讨成人烟雾病出血型、缺血型及无症状型患者的影像学特征。方法回顾性分析82例成人烟雾病患者的临床资料、全脑CTA和CTP图像,以20例健康人作为对照组。根据82例成人烟雾病患者临床表现分为脑出血组(32例,64个大脑半球)、脑缺血组(26例,52个大脑半球)和无症状组(24例,48个大脑半球),分析各组CTA改良法Suzuki分级差异、CTP灌注参数值[脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)、达峰时间(TTP)]的差异。结果CTA改良法Suzuki分级结果为无症状组患者多为Ⅰ级(39.6%),脑缺血组患者多为Ⅳ级(59.6%),脑出血组患者多为Ⅱ~Ⅲ级(68.7%),无症状组、脑缺血组、脑出血组任意两组间改良法Suzuki分级情况比较,差异均有统计学意义(P<0.05)。无症状组CBV、CBF、MTT及TTP与对照组比较,差异均无统计学意义(P>0.05)。脑缺血组CBV、CBF明显低于对照组,MTT、TTP较对照组明显延长,差异均有统计学意义(P<0.05)。脑出血组CBV、CBF与对照组比较,差异均无统计学意义(P>0.05),但MTT、TTP较对照组明显延长(P<0.05)。脑缺血组CBV、CBF与脑出血组相比,差异均有统计学意义(P<0.05);无症状组的CBV、CBF、MTT、TTP与脑缺血组相比,差异均有统计学意义(P<0.05);无症状组MTT、TTP与脑出血组相比,差异均有统计学意义(P<0.05)。结论成人烟雾病出血型、缺血型及无症状型患者的脑动脉CTA改良法Suzuki分级及全脑CTP灌注参数具有一定的差异,对临床个性化诊疗具有指导意义。Objective To investigate the image characteristics of hemorrhage type,ischemia type and asymptomatic type in adult patients with moyamoya disease by observing and analyzing the characteristics of the cerebral arterial CT agiography(CTA) and whole brain CT perfusion images.Methods The clinical data of 82 adult patients with moyamoya disease,whole brain CTA and CTP images were retrospectively analyzed.Twenty healthy subjects served as the control group.According to the clinical manifestations,eighty-two adult patients with moyamoya disease were divided into the cerebral hemorrhage group(32 cases,64 cerebral hemispheres),cerebral ischemic group(26 cases,52 cerebral hemispheres) and asymptomatic group(24 cases,48 cerebral hemispheres).The differences of CTA Suzuki classification and CTP perfusion parameter value [brain blood volume(CBV),cerebral blood flow(CBF),mean transit time(MTT),time to peak(TTP)] among the various groups were analyzed.Results The modified Suzuki grading results of CTA showed that the most patients in the asymptomatic group were the grade Ⅰ(39.6%),while the patients in the cerebral ischemia group were the grade Ⅳ(59.6%),and the patients in the cerebral hemorrhage group were the grades Ⅱ-Ⅲ(68.7%).The comparison of the improved Suzuki grading results between any two groups in the symptom group,cerebral ischemia group and cerebral hemorrhage group showed statistically significant difference(P<0.05).CBV,CBF,MTT and TTP had no statistical differences between the asymptomatic group and control group(P>0.05);CBV and CBF had statistical difference between the cerebral ischemia group and control group(P>0.05),while MTT and TTP were significantly prolonged compared with the control group(P<0.05).CBV and CBF had statistical difference between the cerebral ischemic group and cerebral hemorrhage group(P<0.05).CBV,CBF,MTT and TTP had statistical differences between the asymptomatic group and cerebral hemorrhage group(P<0.05).MTT and TTP had statistical difference between the asymptomatic group and cer

关 键 词：CT血管成像 CT灌注成像 成人烟雾病 脑卒中 Suzuki分级 脑灌注参数 

分 类 号：R743.3[医药卫生—神经病学与精神病学]