老年人椎基底动脉延长扩张症的后循环脑血流灌注研究

Posterior Circulation Cerebral Blood Perfusion in Elderly Patients with Vertebrobasilar Dolichoectasia

目的探讨老年人椎基底动脉延长扩张症(VBD)对后循环供血区脑血流量(CBF)的影响,分析老年人基底动脉形态学改变与后循环延迟血流的关系。资料与方法纳入经磁共振血管成像诊断为VBD的24例老年患者(研究组)及正常老年人25例(对照组),测量三维准连续动脉自旋标记灌注成像[标记延迟时间(PLD)=1525 ms,PLD=2525 ms] MR扫描数据,利用SPM 12软件测量顶叶、枕叶、丘脑和小脑皮层的CBF值,并计算后循环延迟脑血流量,比较研究组及对照组延迟脑血流量的差异。结果 PLD=1525 ms时,研究组后循环的CBF值低于对照组,双侧顶叶、枕叶、丘脑、小脑CBF值与对照组比较,差异有统计学意义(P<0.05、P<0.01);PLD=2525 ms时,研究组与对照组后循环的CBF值比较,差异无统计学意义(P>0.05);研究组后循环延迟的脑血流量比大于对照组,双侧顶叶、枕叶、丘脑、小脑延迟脑血流量比与对照组比较,差异有统计学意义(P<0.05、P<0.01)。结论 VBD患者后循环血流速度减慢,延迟灌注现象显著,但不影响CBF最大灌注值。VBD患者后循环CBF较健康人无显著差异。

Purpose To investigate the effect of vertebrobasilar dolichoectasia (VBD) on cerebral blood flow (CBF) in posterior circulating blood supply area, and to analyze the relationship between morphological changes of basal artery and posterior cyclic delayed blood flow in the elderly. Materials and Methods Twenty-four elderly patients (study group) diagnosed by magnetic resonance angiography (VBD) and 25 cases of normal elderly (control group) were enrolled, and three-dimensional pseudocontinuous arterial spin labeling imaging [post labeling delay (PLD)=1525 ms, PLD=2525 ms] MR scanning data was measured. The CBF values of parietal lobe, occipital lobe, thalamus and cerebellum cortex were measured by SPM 12 software, the posterior cyclic delayed cerebral blood flow was calculated, and the difference of delayed cerebral blood flow was compared between the study group and the control group. Results When PLD=1525 ms, the CBF value of posterior circulation was lower than that of control group, and the difference of bilateral parietal lobe, occipital lobe, thalamus and cerebellum CBF was statistically significant compared with that of control group (P<0.05, P<0.01). When PLD=2525 ms, the study group compared with the CBF value of the post-cyclic cycle of the control group, There was no statistically significant difference (P>0.05), and the cerebral blood flow ratio was greater than that in the control group, and the difference between the delayed cerebral blood flow ratio of bilateral parietal lobe, occipital lobe, thalamus and cerebellum was statistically significant compared with that of the control group (P<0.05, P<0.01). Conclusion The rate of circulating blood flow slows down in patients with VBD, and the delayed perfusion phenomenon is significant, but it does not affect the maximum perfusion value of CBF. There is no significant difference in the post-circulation CBF of VBD patients than in healthy people.