256层螺旋CT动态容积扫描在烟雾病诊断中的应用价值

Application Value of 256-Slice Spiral Dynamic Volume CT in Diagnosis of Moyamoya Disease

目的探讨256层螺旋CT动态容积扫描在烟雾病诊断中的应用价值。方法选取23例烟雾病患者(烟雾病组)和18例血管无异常的志愿者(对照组),均对其行256层螺旋CT动态容积扫描,将动脉达峰序列作为原始图像,进行容积再现(VR)、最大密度投影(MIP)等后处理。将原始数据导入灌注分析软件,得到脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)、达峰时间(TTP),比较大脑前、中、后动脉分布区的CT灌注参数,并进行统计分析。结果与对照组比较,烟雾病组患者大脑前、中动脉分布区TTP、MTT延长,CBV增高,差异有统计学意义(P<0.01),CBF比较差异无统计学意义(P>0.05);两组患者大脑后动脉分布区的脑CT灌注参数比较,差异无统计学意义(P>0.05)。结论 256层螺旋CT动态容积扫描能很好地显示病变血管部位、狭窄程度及颅底异常血管网改变,对烟雾病诊断有重要的指导意义。

Objective To explore the application value of 256-slice spiral DVCT（Dynamic Volume Computerized Tomography） in diagnosis of MMD（Moyamoya Disease）. Methods Altogether 23 cases of MMD patients（MMD Group） and 18 healthy volunteers（Control Group） were selected and scanned by 256-slice spiral DVCT. The arterial peak sequence was taken as the original image and then processed with adoption of multiple techniques including VR（Volume Rending） and MIP（Maximum Intensity Projection）. With input of the original images into the perfusion analysis software, CBV（Cerebral Blood Volume）, CBF（Cerebral Blood Flow）, MTT（Mean Transit Time） and TTP（Time to Peak） values were acquired. And comparisons and statistical analysis were made between CT perfusion parameters of the distribution areas in ACA（Anterior Cerebral Arteries）, MCA（Middle Cerebral Arteries） and PCA（Posterior Cerebral Arteries）. Results In contrast with Control Group, patients in MMD Group showed longer TTP and MTT as well as larger CBV of the distribution areas in ACA and MCA with statistically significant differences（P〈0.01）; while, the CBF in ACA and MCA as well as the cerebral CT perfusion parameters in PCA between two groups had no statistical differences（P〈0.05）. ConclusionThe 256-slice spiral DVCT revealed its advantages in successful display of the locations of vascular lesions, the degree of stenosis and changes of the abnormal sub-cranial vascular network, which provided significant guidance for diagnosis of MMD.