CT灌注成像在脑卒中患者侧支循环定量评价中的应用价值分析

Application value of CT perfusion imaging in quantitative evaluation of collateral circulation in stroke patients

目的:探讨C T灌注成像在脑卒中患者侧支循环定量评价中的应用价值。方法:选取上海普陀区中心医院2019年4月—2020年4月收治的68例缺血性脑卒中患者,所有患者均接受常规C T平扫和C T灌注成像(C T P)检查。分析患者的脑血容量(CBV)、脑血流量(CBF)、达峰时间(TTP)和平均通过时间(MTT),分析侧支循环良好和不良的患者的C T P相关定量参数。结果:68例缺血性脑卒中患者中,有45例患者存在血管狭窄或闭塞。其中,侧支循环良好的21例,侧支循环不良的为24例。侧支循环良好患者C B V、C B F大于侧支循环不良患者,且梗死体积小于侧支循环不良患者。侧支循环良好患者的病灶侧CBF低于健侧,差异有统计学意义(P<0.05);平均通过时间,侧支循环良好患者病灶侧MTT、TTP长于健侧,差异有统计学意义(P<0.05)。侧支循环不良患者病灶侧CBV、CBF低于健侧,病灶侧M T T、T T P长于健侧,差异均有统计学意义(P<0.05)。结论:C T P检查可获取到患者的C T P相关参数,这些参数可评价侧支循环情况,继而帮助医师制定临床治疗方案,预测患者结局。

Objective To explore the application value of CT perfusion imaging in the quantitative evaluation of collateral circulation in stroke patients.Methods 68 patients with ischemic stroke treated in Shanghai Putuo District Central Hospital from April 2019 to April 2020 were selected as the research object.All patients underwent routine CT plain scan and CT perfusion imaging(CTP).The cerebral blood volume(CBV),cerebral blood flow(CBF),time to peak(TTP)and mean transit time(MTT)were analyzed,and the quantitative parameters related to CTP in patients with good and poor collateral circulation were analyzed.Results Among 68 patients with ischemic stroke,45 patients had vascular stenosis or occlusion,and 24/21 had good/poor collateral circulation.CBV and CBF in patients with good collateral circulation were greater than those with poor collateral circulation,and the infarct volume was smaller than those with poor collateral circulation.The CBF of patients with good collateral circulation was significantly lower than that of healthy side(P<0.05);,The mean transit time,MTT and TTP on the lesion side of patients with good collateral circulation were significantly longer than those on the health test(P<0.05).CBV and CBF in the lesion side were significantly lower than those in the healthy side,and MTT and TTP in the lesion side were significantly longer than those in the healthy test(P<0.05).Conclusion CTP examination can obtain CTP related parameters of patients,which can evaluate collateral circulation and help doctors formulate clinical treatment plans for predict patient outcomes.