64层螺旋CT脑灌注联合CT血管造影对颈内动脉狭窄或闭塞的应用

The evaluation of CT perfusion and CT angiography in stenosis or occlusion of internal carotid artery

目的探讨64层螺旋CT脑灌注(CTP)联合CT血管造影(CTA)对颈内动脉狭窄或闭塞的应用价值。方法根据病史或临床症状及体征诊断为颈内动脉及其分支的狭窄或闭塞50例患者分别行CTP和CTA扫描,评价CTP参数平均通过时间(MTT)、对比剂峰值时间(TTP)、脑血流量(CBF)、脑血容量(CBV)以及造影后颈内动脉狭窄程度。结果36例TIA患者患侧MTT延长较健侧具有显著性意义,rCBF侧较健侧无显著性意义,rCBV患侧较健侧无显著性意义。34例梗死组患者患侧MTT延长较健侧有显著性意义,rCBF患侧较健侧无显著性意义,rCBV患侧较健侧无显著性意义。结论 CTP联合CTA可以同时判断颈内动脉狭窄和脑组织局部血流灌注情况。

Objective To evaluate the clinical application of CT perfusion （CTP） and CT angiography （CTA） in stenosis or occlusion of internal carotid artery. Methods CTP and CTA were performed on 50 patients with internal carotid artery stenosis or occlusion. The MTT, TTP, CBF, and CBV were evaluated. The stenosis of internal carotid artery Was also assessed. Results The difference in MTT of affected side was not statistically significant between control group compared with that of the control group （ P〉0.05） in the TIA group. In the cerebral infarction group, MTT of affected side was significantly prolonged （ P 〈0.01）. Conclusion CTP and CTA could provide valuable diagnostic information for patients with stenosis or occlusion of internal carotid artery. The combination of CTP and CTA is not only useful in observing the morphology of internal carotid arteries, but also in observing the homodynamic changes of the brain, which is important for further general individual analysis.