程晓青,田建明,卢光明,左长京,刘嘉,徐嘉璐.CT灌注成像评价单侧颈动脉闭塞脑血流动力学与侧支代偿方式[J].中国医学影像技术,2011,27(6):1183~1187
CT灌注成像评价单侧颈动脉闭塞脑血流动力学与侧支代偿方式
CT perfusion in evaluation of cerebral hemodynamics and collateral flow in unilateral carotid artery occlusion
投稿时间:2011-01-05  修订日期:2011-02-18
DOI:
中文关键词:  颈动脉  脑血管障碍  侧支循环  灌注成像  体层摄影术,X线计算机  血管造影术
英文关键词:Carotid arteries  Cerebrovascular disorders  Collateral circulation  Perfusion imaging  Tomography, X-ray computed  Angiography
基金项目:
作者单位E-mail
程晓青 南京军区南京总医院医学影像科,江苏 南京 210002  
田建明 第二军医大学附属长海医院医学影像科,上海 200433 rabbitkiller80@126.com 
卢光明 南京军区南京总医院医学影像科,江苏 南京 210002  
左长京 第二军医大学附属长海医院核医学科,上海 200433  
刘嘉 第二军医大学附属长海医院医学影像科,上海 200433  
徐嘉璐 第二军医大学附属长海医院医学影像科,上海 200433  
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中文摘要:
       目的 探讨CT灌注成像(CTP)联合DSA评估单侧颈动脉闭塞(CAO)患者侧支代偿方式对脑血流动力学状态影响的价值。 方法 根据DSA结果将38例患者按不同侧支代偿方式分为两组:单纯初级侧支代偿组(n=14,Ⅰ组)和次级侧支代偿或初级和次级侧支共同代偿组(n=24,Ⅱ组),分别计算两组患者闭塞侧与对侧CTP参数的均值(CBF、CBV、TTP)和相对比值(rCBF、rCBV、rTTP)。比较两组患者闭塞侧与对侧及组间血流动力学差异。 结果 第Ⅰ组患者闭塞侧与对侧相比仅TTP值延长(t=7.54,P<0.01);第Ⅱ组患者闭塞侧CBV和TTP值较对侧增大(t=5.49、10.70,P均<0.01)。两组rCBF差异无统计学意义(Z=0.68,P=0.494),rCBV与rTTP差异均有统计学意义(Z=2.32、4.50,P均<0.05)。 结论 CTP联合DSA可全面评价CAO患者脑血流动力学损伤情况以及不同侧支代偿方式脑血流动力学的差异。
英文摘要:
      Objective To assess the value of combination of CT perfusion (CTP) and DSA in evaluating influence of different types of collateral flow on hemodynamic parameters in unilateral carotid artery occlusion (CAO) patients. Methods Thirty-eight patients with symptomatic unilateral CAO were divided into 2 groups according to DSA: Primary collaterals group (n=14, group Ⅰ) and secondary collaterals or primary combined secondary collaterals group (n=24, group Ⅱ). The mean value (CBF, CBV, TTP) and the occluded-to-contralateral ratio (rCBF, rCBV, rTTP) of CTP parameters were measured and compared between two sides and two groups respectively. Results In group Ⅰ, TTP value increased (t=7.54, P<0.01) in the hemisphere ipsilateral to the occlusion. In group Ⅱ, there were significant increase in CBV and TTP value in the hemisphere ipsilateral to the occlusion (t=5.49, 10.70, both P<0.01). Statistical difference of rCBV and rTTP was found between two groups (Z=2.32, 4.50, both P<0.05), while no difference of rCBF was found (Z=0.68, P=0.494). Conclusion Combined DSA and CTP is a good way to evaluate the state of hemodynamic impairment and the difference of hemodynamic condition with different collaterals.
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