CT脑灌注成像联合CTA扫描在颈动脉狭窄评估中的应用价值  

Application of CT Cerebral Perfusion Imaging Combined with CTA Scan in Evaluating Carotid Artery Stenosis

作　　者：唐芳芳 张亚琼 刘霄 TANG Fangfang;ZHANG Yaqiong;LIU Xiao(Yulin Hospital of Traditional Chinese Medicine,Yulin Shaanxi 719000)

机构地区：[1]榆林市中医医院,陕西榆林719000 [2]靖边县人民医院影像中心,陕西榆林718500

出　　处：《医学临床研究》2024年第12期1882-1885,共4页Journal of Clinical Research

摘　　要：【目的】探讨CT脑灌注成像(CTP)联合CT血管成像(CTA)在颈动脉狭窄评估中的应用价值。【方法】回顾性分析2021年2月至2023年2月本院收治的117例疑似颈动脉狭窄患者的影像资料,根据双侧CTA检测结果将其分为轻度狭窄组(n=41)、中度狭窄组(n=44)、重度狭窄及闭塞组(n=32),根据双侧颈动脉狭窄情况将上述患者的颈动脉分为正常组(n=86)、轻度组(n=41)、中度组(n=44)、重度及闭塞组(n=63)。所有患者均进行CTP及CTA检查,比较研究对象相对脑血容量(sCBV)、相对脑血流量(sCBF)、相对平均通过时间(sMTT)、相对达峰时间(sTTP)、颈内动脉的峰值血流速度(PSV)、舒张末血流速度(EDV)以及大脑中动脉的脉搏指数(PI)、平均血流速度(V_(m))。【结果】正常组sCBV、sCBF、sMTT和sTTP与轻度组、中度组、重度及闭塞组比较,差异有统计学意义(P<0.05)。轻度组、中度组、重度及闭塞组sCBV、sCBF呈下降趋势,sMTT、sTTP呈上升趋势,差异有统计学意义(P<0.05)。正常组PI、V_(m)、PSV、EDV与中度组、重度及闭塞组比较,差异有统计学意义(P<0.05)。轻度组、中度组、重度及闭塞组PI、V_(m)呈下降趋势,PSV、EDV呈上升趋势,差异有统计学意义(P<0.05)。【结论】颈动脉狭窄程度越高,脑部血管血流储备越低,CTP联合CTA扫描在脑缺血早期诊断中具有重要价值,可显示颈动脉狭窄患者的血流动力学改变,为临床早期治疗提供可靠的依据。【Objective】To explore the value of CT Perfusion Imaging(CTP)combined with CT Angiography(CTA)in the diagnosis of the degree of carotid artery stenosis.【Methods】A retrospective analysis was conducted on the imaging data of 117 suspected carotid artery stenosis patients admitted to our hospital from February 2021 to February 2023.Based on the CTA detection results,they were divided into the mild stenosis group(n=41),moderate stenosis group(n=44),and severe stenosis and occlusion group(n=32).According to the degree of carotid artery stenosis,the patients'carotid arteries were divided into normal group(n=86),mild group(n=41),moderate group(n=44),and severe and occlusion group(n=63).All patients underwent both CTP and CTA examinations to compare the relative cerebral blood volume(sCBV),relative cerebral blood flow(sCBF),relative mean transit time(sMTT),relative time to peak(sTTP),peak blood flow velocity(PSV)and end diastolic blood flow velocity(EDV)of the internal carotid artery,as well as the pulse index(PI)and mean blood flow velocity(V_(m))of the middle cerebral artery.【Results】The differences in sCBV,sCBF,sMTT,and sTTP between the carotid artery stenosis groups(normal group and mild group,moderate group,severe,and occlusion group)were statistically significant(P<0.05).The sCBV and sCBF of mild group,moderate group,severe and occlusive group showed a decreasing trend,while sMTT and sTTP showed an increasing trend,with statistically significant differences(P<0.05).There was a statistically significant difference(P<0.05)in PI,V_(m),PSV,and EDV between the normal group and carotid artery stenosis groups(moderate group,severe group,and occlusion group).The PI and V_(m) of the mild group,moderate group,severe and occlusion group showed a decreasing trend,while the PSV and EDV showed an increasing trend,with statistically significant differences(P<0.05).【Conclusion】The higher the degree of carotid artery stenosis,the less cerebral vascular blood flow reserve.CT cerebral perfusion imaging combined with CT

关 键 词：颈动脉狭窄 体层摄影术 螺旋计算机 计算机体层摄影血管造影术 

分 类 号：R743[医药卫生—神经病学与精神病学]