256层CT灌注成像对急性脑梗死侧支循环的评估价值  

Evaluated Value of 256-slice CT Perfusion Imaging on Collateral Circulation in Acute Cerebral Infarction

作　　者：陈阳 徐爱民 田成斌 李宁 CHEN Yang;XU Ai-min;TIAN Cheng-bin;LI Ning(Department of Radiology,Pingmei Shenma Medical Group General Hospital,Pingdingshan 467000,Henan Province,China;Department of Radiology,Pingdingshan Hospital of Traditional Chinese Medicine,Pingdingshan 467000,Henan Province,China)

机构地区：[1]平煤神马医疗集团总医院放射科 [2]平顶山市中医医院放射科,河南平顶山467000

出　　处：《中国CT和MRI杂志》2025年第4期7-9,共3页Chinese Journal of CT and MRI

基　　金：2022年度河南省中医药科学研究专项课题项目(2022ZY2067)。

摘　　要：目的分析256层CT灌注成像(CTPI)对急性脑梗死侧支循环的评估价值。方法回顾性分析2021年10月至2023年10月我院收治的74例急性脑梗死患者临床资料,均接受CTPI检查,按照侧支循环情况分为侧支循环良好组(44例)、侧支循环不良组(30例),比较两组一般资料、健侧与患侧灌注参数[脑血容量(CBV)、脑血流量(CBF)、达峰时间阈值(TTP)和平均通过时间(MTT)],入院时、治疗7d后的神经功能缺损程度[美国国立卫生研究院卒中量表(NIHSS)]及短期预后。结果两组性别比较有统计学差异(P<0.05),年龄、入院血压、合并症等比较无统计学意义(P>0.05)。侧支循环良好组患侧CBV、TTP、MTT均明显高于健侧(P<0.05);侧支循环不良组患侧CBF明显低于健侧,TTP及MTT明显高于健侧(P<0.05)。侧支循环良好组CBV、MTT明显高于侧支循环不良组(P<0.05),两组CBF、TTP比较无明显差异(P>0.05)。治疗7d后,两组NIHSS评分均显著降低(P<0.05),且侧支循环良好组入院时、治疗7d后的评分均明显低于侧支循环不良组(P<0.05)。出院3个月内,侧支循环良好组改良Rankin量表评分及脑梗死再发率均明显低于侧支循环不良组(P<0.05)。结论256层CTPI能准确评估急性脑梗死侧支循环的开放程度,且良好的侧支循环可为临床制定个体治疗方案提供更全面影像学依据,对改善患者预后具有重要价值。Objective To analyze the evaluated value of 256-slice CT perfusion imaging(CTPI)on collateral circulation in acute cerebral infarction.Methods The clinical data of 74 patients with acute cerebral infarction were retrospectively analyzed in our hospital from October 2021 to October 2023.All patients received CTPI examination.According to the collateral circulation status,the patients were classified into good collateral circulation group(44 cases)and poor collateral circulation group(30 cases).The general data,perfusion parameters of the healthy side and the affected side[cerebral blood volume(CBV),cerebral blood flow(CBF),time to peak(TT P),mean transit time(MTT)],neurological deficit degree[National Institutes of Health Stroke Scale(NIHSS)]at admission and after 7 days of treatment and short-term prognosis were compared between groups.Results There was a statistical difference in gender between the two groups(P<0.05),but there were no statistically significant differences in age,blood pressure at admission and comorbidity(P>0.05).In good collateral circulation group,the CBV,TT P and MTT of the affected side were significantly higher than those of the healthy side(P<0.05).In poor collateral circulation group,the CBF of the affected side was significantly lower while the TT P and MTT were significantly higher than those of the healthy side(P<0.05).The CBV and MTT in good collateral circulation group were significantly higher than those in poor collateral circulation group(P<0.05).There were no significant differences in CBF and TT P between groups(P>0.05).After 7 days of treatment,the NIHSS score in both groups was declined significantly(P<0.05),and the scores in good collateral circulation group at admission and after 7 days of treatment were significantly lower compared with those in poor collateral circulation group(P<0.05).Within 3 months after discharge,the modified Rankin scale score and recurrence rate of cerebral infarction in good collateral circulation group were significantly lower compared to poor coll

关 键 词：急性脑梗死 侧支循环 CT灌注成像 灌注参数 神经功能缺损程度 改良Rankin量表 

分 类 号：R651.1[医药卫生—外科学]