慢性脑供血不足患者脑血流变化与颈动脉内膜中层厚度关系的相关性研究

Relation between cerebral blood flow and carotid IMT in patients with chronic cerebral circulation insufficiency

目的探讨慢性脑供血不足(CCCI)患者脑血流变化与颈动脉内膜中层厚度(CIMT)的关系。方法采用64层螺旋CT对40例CCCI患者(CCCI组)和20例正常对照者(对照组)进行脑血流灌注成像检查,分别在额叶、颞叶、顶叶、枕叶、豆状核、丘脑及深部白质手绘感兴趣区,测量脑血流量、脑血容量、平均通过时间和达峰时间,比较2组CIMT值差异及与上述参数的相关性。结果与对照组比较,CCCI组CIMT值明显升高,差异有统计学意义[(0.83±0.28)mmvs(1.35±0.61)mm,P<0.05];CCCI组额叶、深部白质的脑血流量与CIMT呈负相关(r=-0.38,r=-0.56,P=0.04),达峰时间与CIMT呈正相关(r=0.81,r=0.85,P=0.01),其余部位、参数与CIMT值无相关性。结论 CCCI患者CIMT值增加,其脑CT灌注变化能较好地反映动脉粥样硬化程度。

Objective To study the relation between cerebral blood flow （CBF） and carotid IMT in patients with chronic cerebral circulation insufficiency （CCCI）. Methods Forty patients with CCCI served as a CCCI group and 20 normal subjects served as a control group according to their spiral CT perfusion imaging. Regions of interest in frontal, temporal, parietal and occipital lobes, lenticulate,thalamus and deep white matter were plotted. CBF, CBV, MTT and TTP were meas- ured and their relation with carotid IMT was compared. Results The carotid IMT was signifi- cantly larger in CCCI group than in control group （0. 83±0. 28 mm vs 1. 35±0. 61 ram, P〈0.05）. The CBF in temporal lobe and deep white matter was negatively related with the carotid IMT whereas the TTP was positively related with the carotid IMT in CCCI group （r=-0.38,r=-0.56,P=0.04;r=0.81,r=0.85,P=0.01）. The CBF in frontal,parietal and occipital lobes, lenticulate and thalamus was not related with the carotid IMT matter. Conclusion The carotid IMT is larger in CCCI patients whose brain CT perfusion imaging can reflect the severity of their arthrosclerosis.