iFlow成像技术对中脑周围非动脉瘤性蛛网膜下腔出血后脑血管痉挛的评估

Assessment of the cerebral vasospasm after perimesencephalic nonaneurysmal subarachnoid hemorrhage with i Flow imaging technique

目的探讨iFlow成像技术在中脑周围非动脉瘤性蛛网膜下腔出血(PNSAH)后脑血管痉挛评估中的价值。方法收集经CT及两次血管造影明确诊断为PNSAH 60例为观察组,收集我院同期颅内动脉瘤单纯弹簧圈栓塞治疗后半年以上随访复查造影时未见复发60例为对照组。利用西门子公司iFlow软件测量首次造影和复查造影时双侧颈内动脉分叉部、双侧大脑中动脉分叉部、双侧椎动脉造影基底动脉末端相同部位的造影剂达峰时间(TTP)。结果与对照组相比,观察组首次造影中双侧椎-基底动脉末端造影剂TTP明显增高(P<0.05),观察组复查造影中双侧椎-基底动脉末端、右侧颈内分叉部、右侧大脑中分叉部造影剂TTP均明显增高(P<0.05)。与首次造影相比,观察组复查造影双侧椎-基底动脉末端造影剂TTP明显增高(P<0.05)。结论PNSAH后存在血管痉挛,且以基底动脉最明显,应用i Flow技术评估脑血管痉挛的具有可行性。

Objective To explore the assessment of the cerebral vasospasm after Perimesencephalic nonaneurysmal subarachnoid hemorrhage(PNSAH)with iFlow imaging technique.Method The observed group included 60 patients who were diagnosed as PNSAH and 60 subjects with normal hemodynamic served as the control.Time to peak(TTP)of the same-part of the bifurcations of bilateral internal carotid arteries,bifurcations of bilateral middle cerebral arteries,tips of bilateral vertebrobasilar arteries were determined by iFlow software(DSA machine,Siemens)in both the groups.Results The TTP in the tips of bilateral vertebrobasilar arteries(at first-visit angiography)is significantly longer in the observed group than that in the control group(P<0.05).The TTP in tips of bilateral vertebrobasilar arteries,right internal carotid bifurcation and right cerebral middle artery bifurcation was significantly longer in the observed group than that in the control group when the angiography was examined again(P<0.05).The TTP in the tips of bilateral vertebrobasilar arteries was significantly longer when the angiography was examined again than that at first visit angiography in the observed group(P<0.05).Conclusions The vasospasm occurs,especially in the vertebrobasilar arteries in the patients with PNSAH.The iFlow imaging technique is a feasible method to assess the cerebral vasospasm in the patients with PNSAH.