大脑中动脉不同监测位置对双源CT全脑灌注成像参数的影响

Influence of different monitor location of middle cerebral artery on whole-brain CT perfusion parameters with dual source CT

目的探讨双源CT全脑灌注成像后处理大脑中动脉不同监测位置对灌注成像参数的影响。方法回顾性分析本溪市中心医院2019年3月至2020年1月行全脑CT灌注成像检查患者35例的双源CT全脑灌注成像资料,每例数据进行3次图像后处理,分别选取颈内动脉C1段、大脑中动脉M1段、大脑中动脉M2段作为输入动脉的监测位置。取右侧颞极连续3个层面绘制感兴趣区(ROI),测量全脑灌注成像的脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)、排空时间(TTD),取3个层面的平均值,采用自身对照研究进行分析。结果监测位置为C1的各个灌注参数分别为CBF(75.699±15.491)mL·100 mL^-1·min^-1、CBV(4.892±0.725)mL/100 mL、MTT(4.375±0.745)s、TTD(3.926±1.049)s;监测位置为M1的各个灌注参数分别为CBF(74.219±12.722)mL·100 mL^-1·min^-1、CBV(4.982±1.072)mL/100 mL、MTT(4.475±0.871)s、TTD(4.115±1.164)s;监测位置为M2的各个灌注参数分别为CBF(71.431±14.743)mL·100 mL^-1·min^-1、CBV(4.797±1.021)mL/100 mL、MTT(4.620±0.936)s、TTD(4.105±1.249)s。监测位置为C1与M1间的各灌注参数差异均无统计学意义(均P>0.05)。监测位置C1与M2间的CBF、MTT参数差异均有统计学意义(CBF:t=2.600,P<0.05;MTT:t=-2.510,P<0.05),而两者间CBV、TTD参数值差异均无统计学意义(均P>0.05)。监测位置M1与M2两者间的CBF、MTT参数值差异均有统计学意义(CBF:t=2.277,P<0.05;MTT:t=-2.371,P<0.05),而两者间CBV、TTD参数值差异均无统计学意义(均P>0.05)。结论选择不同监测位置对全脑灌注成像参数值有一定影响,因此在进行全脑CT灌注成像后处理时,应尽量选颈内动脉C1或大脑中动脉M1段作为监测位置。

Objective To explore the influence of different monitor location of middle cerebral artery on cerebral blood perfusion parameters of dual source CT whole brain perfusion imaging.Methods The data of dual source CT whole brain perfusion imaging in 35 patients of Benxi Central Hospital from March 2019 to January 2020 were retrospectively analyzed.Every data was reconstructed 3 times,M1 segment of internal carotid artery,C1 segment and C2 segment of middle cerebral artery were chosen to be the monitor location of input artery respectively.Drew ROI in continuous three levels of right temporal pole,recorded cerebral blood flow(CBF),cerebral blood volume(CBV),mean transit time(MTT)and time to drain(TTD)of ROI,the average value of ROI in the three levels could be got,using self-control method,the two related data were analysed with paired t test.Results When C1 segment was regarded as the monitor locations,the parameters were as following:CBF(75.699±15.491)mL·100mL^-1·min^-1,CBV(4.892±0.725)mL/100mL,MTT(4.375±0.745)s,TTD(3.926±1.049)s.When M1 segment was regarded as the monitor locations,the parameters were as following:CBF(74.219±12.722)mL·100^-1·min^-1,CBV(4.982±1.072)mL/100mL,MTT(4.475±0.871)s,TTD(4.115±1.164)s.When M1 segment was regarded as the monitor locations,the parameters were as following:CBF(71.431±14.743)mL·100mL^-1·min^-1,CBV(4.797±1.021)mL/100mL,MTT(4.620±0.936)s,TTD(4.105±1.249)s.There was no statistically significant difference among all parameters when C1 segment and M1 segment was regarded as the monitor locations(all P>0.05).When C1 and M2 segment were regarded as the monitor locations,there were statistically significant differences in CBF and MTT between them(CBF:t=2.600,P<0.05;MTT:t=-2.510,P<0.05),but there were no statistically significant differences in CBV or TTD between them(all P>0.05).When M1 and M2 segment were regarded as the monitor locations,there were statistically significant differences in CBF and MTT between them(CBF:t=2.277,P<0.05;MTT:t=-2.371,P<0.05),but there were no statistically significant differences in CBV or TTD between them(all P>0.05).Conclusion Choosing different monitor locations of input artery has influence on the parameters of CT whole brain perfusion imaging.Therefore,in the reconstruction of cerebral CT perfusion,the monitor location of input artery should select C1 segment of internal carotid artery or M1 segment of middle cerebral artery.