CT血管成像与CT灌注成像对缺血性脑卒中患者脑侧支循环形成的评价

Evaluation of Collateral Circulation Formation in Patients with Ischemic Stroke by CT Angiography and CT Perfusion Imaging

目的探讨CT血管成像与CT灌注成像对缺血性脑卒中患者脑侧支循环形成的评价。方法选取2017年3月至2019年3月我院收治的缺血性脑卒中患者204例,根据患者情况分为轻中度狭窄组与重度狭窄或闭塞组。比较两组患者脑侧支循环、神经功能缺损、认知功能的情况及脑侧支血流较好组与血流减少组的CT血管成像结果。结果重度狭窄或闭塞组韦利斯氏(Willis)环后循环与软脑膜吻合支开放率高于轻中度狭窄组(P<0.05);重度狭窄或闭塞组神经功能缺损、认知功能小于轻中度狭窄组(P<0.05);血流较好组的MTT结果小于血流减少组(P<0.05),血流较好组的CBV、CBF、检出发病时间大于血流减少组(P<0.05)。结论缺血性脑卒中患者脑侧支循环形成的评价中,CT血管成像可以对患者的血流动力学情况进行观察,同时可以对患者的脑侧支循环状态进行了解,有利于为临床治疗缺血性脑卒中患者提供一定的科学依据。

Objective To evaluate the formation of cerebral collateral circulation in patients with ischemic stroke by CT angiography and CT perfusion imaging.Methods 204 patients with ischemic stroke admitted to our hospital from march 2017 to march 2019 were selected and divided into mild to moderate stenosis group and seve re stenosis or occlusion group.The ce re b ral collate ral circulation,neurological deficit,cognitive function and CT angiography results of the two groups were compared.Results in severe stenosis or occlusion group,the opening rate of anastomotic branches of Willis’ ring posterior circulation and pia mater was higher than that in mild to moderate stenosis group(P<0.05);in severe stenosis or occlusion group,the neurological deficit and cognitive function were lower than those in mild to moderate stenosis group(P<0.05);in better blood flow group,the MTT results were lower than those in blood flow reduction group(P<0.05);in better blood flow group,CBV,CBF,CBV,CBF were detected The duration of the disease was longer than that of the decreased blood flow group(P<0.05).Conclusion In the evaluation of the formation of cerebral collateral circulation in patients with ischemic stroke,CT angiography can observe the hemodynamics of patients and understand the state of cerebral collateral circulation of patients,which is conducive to provide certain scientific basis for clinical treatment of patients with ischemic stroke.