数字减影血管造影联合CT灌注成像在颈内动脉系统脑梗死中的诊断价值

Application of CT perfusion imaging and DSA in diagnosis of cerebral infarction in internal carotid

目的明确颈内动脉系统脑梗死患者的动脉狭窄和脑血流灌注情况,并对数字减影血管造影(DSA)联合CT脑灌注成像(CTP)的诊断价值进行评价。方法收集66例颈内动脉系统脑梗死患者,分别应用DSA和CTP的方法,对颈内动脉系统血管狭窄和脑血流灌注情况进行分析。结果(1)66例患者中均发现与临床症状相对应的责任梗死灶,其中42例为多灶梗死;(2)66例患者中55例发现颈内动脉系统的血管狭窄共87处,最常发生于动脉分叉和血管弯曲处,轻、中、重度狭窄和完全闭塞分别为35、35、14、3处;(3)66例患者中52例CTP检查发现与责任病灶相符的脑灌注异常区,表现为脑血流量明显降低,平均通过时间和达峰时间显著延迟。结论DSA联合CTP能够同时从血管形态和功能上反映脑血管病变和血流灌注情况,为临床治疗提供依据,对脑梗死具有较高的诊断价值。

Objective To identify the arterial stenosis and cerebral blood perfusion in patients of cerebral infarction in inteunal carotid,and analyze the value of CTP and DSA in diagnosis of this disease. Methods The changes of arterial stenosis and cerebral blood perfusion in 66 patients suffered from cerebral infarction in carotid were detected by DSA and CTP,respectively. Results （1） Infarcts which corresponded to symptoms were existed in all of 66 patients. Multi-infarction were existed in 42 patients. （2）55 patients have 87 arterial stenosis which located mostly in bifurcates and crooks of artery. The slight stenosis, moderate stenosis, severe stenosis and occlusion were 35,35,14,3 respectively. （3）The abnormal cerebral perfusion（including decrease of CBV and delayed TTP and MTT） which corresponded to the infarction were founded in 52 patients. Conclusion DSA and CTP can detect the changes of cerebral vascular and perfusion,which are helpful in diagnosis and therapy of cerebral infarcion.