症状性颈动脉狭窄介入治疗的术前评估

Preoperative evaluation of interventional therapy for symptom carotid artery stenosis

目的通过对颈动脉狭窄患者进行综合术前评估,选择介入治疗适应证。方法30例颈动脉狭窄患者,进行MRI、DSA和CTP检查,讨论脑血管狭窄程度、部位、侧支循环和脑血流动力学状态之间的关系。结果患侧与健侧相比,MTT和TTP具有统计学意义(P=0.005和0.002);狭窄程度与CTP分级之间无明显相关性(r=0.63,P=0.13);侧支循环越差梗死发生率越高(r=1.0,P=0.017);灌注越低梗死发生率越高(r=0.999,P=0.033)。结论对于颈动脉狭窄患者应该进行MRI、DSA和CTP的综合分析,以指导临床诊断、治疗及预后等。

Objective According to the comprehensive preoperative evaluation for the patients with carotid artery stenosis,to choice the indication of intervention. Methods 30 patients with carotid artery stenosis were accepted magnetic resonance imaging （MRI）, digital subtraction angiography （DSA） and computed tomography perfusion （CTP） to discuss the relationships of the degree of stenosis, location of stenosis, collateral circulation and cerebral hemodynamics. Results To compare with the symptomatic and nonsymptomatic hemisphere, MTT and TTP had statistical significance （P = 0. 005, 0. 002）; There was no significant correlation between the degree of stenosis and the grade of CTP （r=0.63, P=0.13） ; The less collateral circulation, the higher rate of infarction （r= 1.0, P= 0.017）; The lower grade of perfusion, the higher rate of infarction （r=0. 999, P=0. 033）. Conclusion In order to guide the clinical diagnosis and therapy and prognosis, we need to undertake the comprehensive analysis of MRI, DSA and CTP for the patients with carotid artery stenosis.