64排VCT脑灌注成像对烟雾病的血流动力学研究

Assessment of Cerebral Hemodynamics by 64-Row VCT Perfusion Imaging in Patients with Moya-Moya Disease

目的通过对烟雾病患者进行64排VCT脑灌注成像,了解其脑血流动力学变化情况,包括脑血流量、脑血容量、平均通过时间及达峰时间,为临床干预治疗提供影像学依据。方法 30例烟雾病患者,男性14例,女性16例,年龄最大为49岁,最小为13岁,平均年龄为33.8岁。利用GE公司生产的LightSpeed VCT螺旋扫描机对烟雾病患者进行灌注扫描,速率5mL·s-1、剂量50mL、扫描延迟5s、扫描时间45s,然后用该公司配备的Perfusion4专门软件对所得图像进行后处理,分析责任区域的脑血流量、脑血容量、平均通过时间及达峰时间,从而了解其血流动力学变化情况。结果 30例烟雾病患者当中,缺血型患者9例,出血型患者21例。3例显示局部脑血流量增加,5例显示局部脑血流量减少,3例显示局部脑血容量增加,27例显示脑血容量正常,3例显示平均通过时间及达峰时间缩短,8例显示平均通过时间及达峰时间延长。结论缺血型烟雾病患者大部分表现为局部低灌注,出血型烟雾病患者表现为正常或局部高灌注,平均通过时间和达峰时间是反映脑血流动力学变化较敏感的指标。

Objective To investigate the changes in cerebral hemodynamics（cerebral blood flow volume,blood capacity,mean transit time and time to peak）using 64-row VCT perfusion imaging,and to provide imaging evidence for clinical intervention.Methods Thirty patients with moya-moya disease aged 13-49years（average age 33.8years,14males,16females）were recruited in this study.Cerebral perfusion imaging was performed using a GE LightSpeed VCT scanner at a rate of 5mL/second and a dose of 50mL.The scan delay time was 5seconds and scan time was 45seconds.Post-processing was conducted with Perfusion 4software to analyze cerebral blood flow volume,blood capacity,mean transit time and time to peak.Results Of the 30patients,9had ischemic type moya-moya disease and 21had hemorrhagic type moya-moya disease.The 64-row VCT perfusion imaging showed increased regional cerebral blood flow in 3patients,decreased regional cerebral blood flow in 5,increased regional cerebral blood volume in 3,normal cerebral blood volume in 27,shortened mean transit time and time to peak in 3,and prolonged mean transit time and time to peak in 8.Conclusion Most patients with ischemic type moya-moya disease are characterized by regional hypoperfusion,while patients with hemorrhagic type moya-moya disease are characterized by normal or regional hyperperfusion.The mean transit time and time to peak are sensitive indicators of changes in cerebral hemodynamics.