动态CTA结合CTP成像对偏头痛患者血管形态学及脑血流量改变的评价

Value of dynamic CTA combined with CTP imaging in the evaluation of vascular morphological changes and cerebral blood flow changes in patients with migraine

目的分析动态CT血管造影(CTA)结合CT灌注成像(CTP)在偏头痛患者血管形态学改变及脑血流量改变评价中的价值。方法选取2021-08—2023-08大庆油田总医院收治的60例偏头痛患者为研究对象,根据患者是否存在先兆症状分为MA组(32例)和MoA组(28例),所有患者在偏头痛症状消失3 d后的非发作期(对照组)再次进行颅脑动态CTA与CTP检查,并与发作期进行对比,比较MA组、MoA组血管痉挛、血流量异常发生率、rCBF变化情况及不同脑叶镜像ROI区血流量AI值。结果MA组患者的血管痉挛发生率31.25%,rCBF增加发生率59.38%,均高于MoA组的7.14%、17.86%,rCBF减少的发生率25.00%,低于MoA组的64.29%,差异均有统计学意义(P<0.05)。2组患者的头痛位置比较差异无统计学意义(P>0.05)。MA组、MoA组与对照组额叶、颞叶、枕叶、小脑、顶叶等不同脑叶镜像ROI区血流量AI值比较,差异均有统计学意义(P<0.05)。结论CTA结合CTP检查能够较好地评价偏头痛患者血管形态学及脑血流量改变,可作为临床诊疗的重要依据。

Objective To analyze the value of dynamic CT angiography(CTA)combined with CT perfusion imaging(CTP)in the evaluation of vascular morphological and cerebral blood flow changes in patients with migraine.Methods From August 2021 to August 2023,60 migraine patients in Daqing Oilfield General Hospital were selected and were divided into MA group(32 cases)and MoA group(28 cases).All patients were examined for brain dynamic CTA and CTP at non-episodic phase 3 days after migraine symptoms disappeared,as control group,and compared with the seizure period.The incidence of vasospasm,abnormal blood flow,changes in rCBF and blood flow AI values in different lobular image ROI regions in MA group and MoA group were compared.Results The incidence of vasospasm was 31.25%and the incidence of rCBF increase was 59.38%,which was higher than that in the MoA group(7.14%and 17.86%,respectively),and the incidence of rCBF reduction(25.00%)was lower than that of the MoA group(64.29%),with statistically significant differences(P<0.05).There was no significant difference in the location of headache between the two groups(P>0.05).Compared to control group,the AI value of blood flow in frontal,temporal,occipital,cerebellar and parietal lobes in the MA group and MoA group had statistically significant differences(P<0.05).Conclusion CTA combined with CTP examination can better evaluate the changes of vascular morphology and cerebral blood flow in migraine patients,which can be used as an important basis for clinical diagnosis and treatment.