乙酰唑胺激发试验CT灌注成像联合CT血管造影对慢性脑供血不足的诊断价值

Clinical value of CT perfusion imaging with acetazolamid excitation test combined with CT angiography in the diagnosis of chronic cerebral circulation insufficiency

目的:探讨乙酰唑胺(ACZ)激发试验CT灌注成像联合CT血管造影对慢性脑供血不足(CCCI)的诊断价值。方法:选取CCCI患者52例为观察组,同期健康体检者48名为对照组。使用ACZ激发试验CT灌流成像联合CT血管造影技术对所有受试者的神经系统进行全面检查;选取脑桥及基底核层面作为感兴趣层,选取椎基底动脉和大脑中动脉、前动脉、后动脉供血区进行标记,采用镜像法测量左右对称区达峰时间、脑血容量、脑血流量及平均通过时间。结果:在使用ACZ激发前,观察组大脑前动脉供血区血容量显著高于对照组(P<0.01),中动脉皮层支供血区达峰时间显著高于对照组(P<0.01);激发后,2组各区域的脑区相关指标差异均有统计学意义(P<0.01)。结论:使用ACZ激发后再采用CT灌注成像联合CT血管造影可有效提高CCCI的临床检出率,该方法操作简便,灵敏度高,在早期即可有效诊断,具有较高的临床价值。

Objective： To investigate the clinical value of CT perfusion imaging with acetazolamid（ ACZ） excitation test combined with CT angiography in the diagnosis of chronic cerebral circulation insufficiency（ CCCI）. Methods： Fifty-two patients with CCCI and 48 healthy examination people were divided into the observation group and control group,respectively. The nervous system in all cases were comprehensively examined using ACZ perfusion imaging combined with CT angiography. The pons and basal layers were studied,and the supply blood area of vertebral basilar artery,and cerebral middle artery,anterior artery and posterior artery were labeled. The peak time of cerebral blood flow,cerebral blood volume,and mean transit time in symmetric area were measured using mirror image method.Results： The volume of the blood supply area of cerebral anterior artery before ACZ excitation in observation group was significantly higher than that in control group（ P〈0. 01）,and the peak time of supply blood area of cerebral middle artery was significantly higher than that in control group（ P〈0. 01）. After ACZ excitation,the differences of the related indicators of different brain areas were statistically significant（ P〈0. 01）. Conclusions： The ACZ perfusion imaging combined with CT angiography can effectively improve the detection rate of CCCI,which is easy to handle,high sensitivity,effective in early diagnosis,and has high clinical value.