CT灌注成像对症状性烟雾病综合征血流动力学的评价研究

CT perfusion in assessment of hemodynamic changes in symptomatic Moyamoya syndrome

目的探讨CT灌注成像(CTP)在评价症状性烟雾病综合征(s MMS)血流动力学中的应用价值。方法回顾性分析行颅脑CTP检查的64例s MMS患者,对患者双侧额叶、颞叶、基底节区感兴趣区进行定量及定性分析,并对症状侧与非症状侧各相对灌注值(rCBF、rCBV、rTTP及rMTT)进行对比分析。结果 s MMS患者症状侧与非症状侧灌注值比较显示:症状侧颞叶及基底节区rCBF值明显降低,rTTP及rMTT值明显延迟。亚组分析显示:对于单侧s MMS,额叶各CTP参数比较均无明显统计学差异;症状侧颞叶及基底节区rTTP值、rMTT值明显延迟,而rCBF值无明显统计学差异;症状侧基底节区rCBV较对侧明显增加。对于双侧s MMS,症状侧额叶、颞叶及基底节区rCBF值明显降低,颞叶及基底节区rTTP及rMTT值明显延迟。结论 CTP能够直观、定量地评价s MMS患者脑血流动力学变化,为临床提供重要的脑组织灌注信息。

Objective To evaluate the utility of CT perfusion （CTP） for the assessment of cerebral hemodynamic changes in patients with Moyamoya syndrome （MMS）. Methods 64 consecutive MMS patients who received CTP were retrospectively studied. The relative perfusion parameter values of symptomatic-side were compared to the non-symptomatie-side. Region of interests （ROIs） were chosen in the nfirroring bilateral frontal lobes, temporal lobes and basal ganglia. Results The rCBF values of symptomatie-side in the temporal lobes and basal ganglia area were significantly lower than the non-symptomatie-side. Meanwhile, the rTTP value and rMTT value of symptomatie-side were significantly delayed. In patients （ n = 15 ） with unilateral sMMS, the differences of all parameters were not significant in the mirroring bilateral frontal lobes. The rTTP value and rMTT value of symptomatic-side in temporal lobes and basal ganglia area were significantly delayed compared to the non-symptomatic-side. However, rCBF values in temporal lobes and basal ganglia areas of symptomatic-side were not significant compared to the non-symptomaticside. The rCBV values of symptomatic-side in the basal ganglia area were significantly higher than the non-symptomatic-side. In patients （n = 49） with bilateral sMMS, the rCBF values of symptomatic-side in the frontal lobes, temporal lobes and basal ganglia area were significantly lower than the non-symptomatic-side. The rTTP value and rMTT value of symptomatic-side in the temporal lobes and basal ganglia area were significantly delayed. Conclusion This study demonstrates that CTP can provide a crucial quantitative and visually assessment of cerebral hemodynamie changes in patients with symptomatic Moyamoya syndrome.