基于一站式头颈CTA及全脑CTP技术对颈动脉源性脑灌注异常的研究

The Research of the Carotid Artery Derived Cerebral Perfusion Abnormity Based on One-stop Intracranial-carotid Artery CTA and Whole Brain CTP

目的:通过一站式头颈CTA及全脑CTP技术对颈动脉狭窄导致的脑灌注异常进行研究,借此成像技术追寻脑灌注异常的脑区分布及演化特征。方法:通过超声检查收集25例无症状颈动脉斑块者及25例健康志愿者,行一站式头颈CTA及全脑CTP成像,将不同颈动脉狭窄程度患者进行分类归纳,对比健康志愿者分析CTP图像中rCBV、rCBF、rMTT指标异常的脑区分布,并进一步探究异常脑区随颈动脉狭窄程度的演变特征。结果:对比健康组,颈动脉轻度狭窄组中全脑的rCBV、rCBF差异无统计学意义(P>0.05),海马区及纹状体的rMTT有轻度延长(P<0.05);对比健康组,颈动脉中度狭窄组中全脑的rCBV差异无统计学意义(P>0.05),海马区、纹状体、内侧颞叶、岛叶及眶额区的rCBF有轻度减低(P<0.05),海马区、纹状体、内侧颞叶、岛叶及眶额区的rMTT有轻度延长(P<0.05);对比健康组,颈动脉重度狭窄组中全脑的rCBV差异无统计学意义(P>0.05),海马区、纹状体、内侧颞叶、岛叶、眶额区的rCBF有轻度减低(P<0.05),海马区、纹状体、内侧颞叶、岛叶、眶额区、前顶叶及枕叶的rMTT有轻度延长(P<0.05)。结论:一站式头颈CTA及全脑CTP技术除了能够准确判断颈动脉狭窄程度外,还能够就异常脑功能区域分布精准显示,并进一步基于颈动脉狭窄程度推演脑功能异常变化趋势。

Objective:To research the abnormal cerebral perfusion caused by carotid artery stenosis through one-stop intracranial-carotid artery CTA and whole brain CTP technique,and trace the distribution and evolution characteristics of brain regions with abnormal cerebral perfusion by this imaging technique.Methods:Collecting 25 patients with asymptomatic carotid plaque and 25 healthy volunteers by ultrasound examination,and then performing the one-stop intracranial-carotid CTA and whole brain CTP,classifying and summarizing these patients with different degree of carotid artery stenosis,analyzing the distribution of abnormal brain regions with rCBV,rCBF and rMTT indexes in CTP images compared with healthy volunteers,and exploring the evolution characteristics of abnormal brain regions with the degree of carotid artery stenosis.Results:Compared with the healthy group,there was no significant difference in rCBV and rCBF of whole brain in mild carotid artery stenosis group(P>0.05),but the rMTT of hippocampus and striatum were slightly prolonged(P<0.05).Compared with the healthy group,there was no significant difference in rCBV of the whole brain in the moderate carotid artery stenosis group(P>0.05),the rCBF of the hippocampus,striatum,medial temporal lobe,insula and orbitofrontal were slightly decreased(P<0.05),and the rMTT of the hippocampus,striatum,medial temporal lobe,insula and orbitofrontal were slightly prolonged(P<0.05).Compared with the healthy group,there was no significant difference in rCBV of the whole brain in the severe carotid artery stenosis group(P>0.05),the rCBF of the hippocampus,striatum,medial temporal lobe,insula,and orbitofrontal lobe were slightly decreased(P<0.05),and the rMTT of the hippocampus,striatum,medial temporal lobe,insula,orbitofrontal,anterior parietal lobe and occipital lobe were slightly prolonged(P<0.05).Conclusion:One-stop intracranial-carotid artery CTA and whole brain CTP technique can not only accurately judge the degree of carotid artery stenosis,but also accurately display the distribution of abnormal brain function regions and further infer the trend of abnormal brain function based on the degree of carotid artery stenosis.