颈内动脉狭窄或闭塞患者的脑血流动力学观察

Study of cerebral hemodynamic feature of internal carotid artery stenosis or occlusion

目的探讨动脉输入函数在脑CT灌注成像(CTP)联合脑血管CT成像(CTA)扫描中的运用及颈内动脉狭窄或闭塞患者的脑血流动力学表现特点。方法对35例临床诊断脑缺血患者行CTP联合CTA检查,将CTP所得动脉输入函数峰值时间作为脑血管CTA扫描的延迟时间,根据CTA和CTP的结果分析颈内动脉狭窄患者的脑血流动力学特点。结果以动脉输入函数峰值时间作为延迟时间所得脑血管CTA图像能清晰显示Willis环和颅内动脉三级分支结构。13例单侧颈内动脉中度及重度或闭塞患者病变侧达峰时间(TTP)与健侧比较差异有显著统计学意义(P<0.01),重度狭窄或闭塞患者病变侧脑血容量(CBV)较健侧明显增高(P<0.05)。结论利用动脉输入函数峰值时间确定脑血管CTA扫描延迟时间具有较高准确性;灌注参数达峰时间(TTP)在显示颈内动脉中、重度或闭塞患者脑灌注缺损区具有较高敏感性。

Objective To assess the value of artery input function in CT perfusion（CTP）combining with CT angiography （CTA）and hemodynamic features of internal carotid artery（ICA）stenosis or occlusion.Methods Thirty-five patients with clinical proofed cerebral ischemia underwent examination of CTP combining with CTA.The peak time of artery input func- tion gained from CTP was taken as the delay time of CTA protocol,then the hemodynamic features of ICA stenosis or occlu- sion were evaluated from the data of CTA and CTP.Results All the CTA images of the Willis circle and the three intracal artery branch were satisfied through the peak time of artery input function.Of the 13 patients with middle and severe unilat- eral ICA stenosis or occlusion,significant difference was found in TTP values（P〈0.01）of abnormal regions between the occluded and the contralateral hemisphere,and CBV values of abnormal hemisphere increased more obviously than that of the contralateral hemisphere（P〈0.05）.Conclusion It＇s an accurate method of using the peak time of artery input function as the delay time of CTA.The TTP values have relatively high sensitivity in evaluating abnormal area of stenosis or occlusion of ICA.