单光子发射型计算机断层显像在颅内外动脉搭桥手术中的应用价值

The Value of Single-Photon Emission Computed Tomography Imaging in Extracranial-Intraeranial Arterial Bypass Surgery

目的采用单光子发射型计算机断层显像(single photon emissiorn computed tomography,SPECT)观察缺血性卒中患者颞浅动脉-大脑中动脉搭桥手术前后脑血流灌注变化,了解SPECT在颅内外动脉搭桥手术中的应用价值。方法对12例缺血性卒中患者手术前后脑血流灌注显像结果进行对比分析,并分别比较手术前和手术后有无侧支代偿患者脑血流灌注显像。结果 12例患者额、颞叶病变侧与对侧相应区域放射性计数比值手术前后有统计学差异(P<0.05),而顶、枕叶、基底节及丘脑手术前后无统计学异(P>0.05)。手术前或手术后有无侧支代偿患者上述各部位病变侧与对侧相应区域放射性计数比值无统计学差异(P>0.05)。结论搭桥手术可改善脑循环代偿不足脑组织的血流灌注,以额、颞叶血流灌注改善明显。

Objective To observe the changes of brain blood flow in patients with ischemic stroke before and after superficial temporal artery to middle cerebral artery （STA-MCA） bypass surgery using single photon emission computed tomography （SPECT）. To find out the value of SPECT in extracranial- intracranial arterial bypass surgery. Methods To analyse the results of 12 patients with ischemic stroke underwent SPECT perfusion scan of cerebral blood flow before and after STA-MCA bypass surgery. To compare the result of cerebral blood flow perfusion scan of patients with collateral circulation or without before and after STA-MCA bypass surgery, respectively. Results The ratio of the impaired area to the opposite area in frontal and temporal lobe in 12 patients has statistical significant difference before and after STA-MCA bypass surgery （P〈0.01）. But in parietal lobe, occipital lobe, basal ganglia and thalamus, that has no statistical significant difference（P〉0.05）. Regardless of whether there is collateral circulation in preoperative or postoperative patients with the above-mentioned parts of the impaired side to the corresponding area in the contralateral side was no statistical difference in the ratio of radioactive counts （P〉0.05）. Conelusion Bypass surgery can improve the cerebral circulation less than compensatory brain tissue perfusion. The blood flow perfusion of frontal and temporal lobe improved significantly.