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-  2018 

CT灌注成像评估脑血运重建治疗动脉闭塞性疾病的效果 Efficacy Assessment of Reascularization in Cerebrovascular Steno-Occlusive Diseases by CT Perfusion Imaging

Keywords: 脑动脉闭塞性疾病,CT灌注成像,颞浅-大脑中动脉搭桥

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Abstract:

目的:通过CT灌注成像来研究颞浅-大脑中动脉搭桥(STA-MCA)+脑-硬脑膜-颞肌血管融通术(EDMS)对脑动脉闭塞性疾病患者(包括烟雾病和非烟雾病缺血性疾病患者)脑血流动力学改善,并评估手术治疗对烟雾病和非烟雾病缺血性疾病疗效的差异。方法:比较手术前与术后3个月感兴趣区域(ROI)相关参数,如:脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)、达峰时间(TTP)的变化。并对搭桥患者进行术后随访,记录患者术后新发出血性或缺血性卒中事件,术后3个月通过NIHSS评分评估患者神经功能。结果:和术前CT灌注结果相比,烟雾病组与非烟雾病组患者术后相对脑血流量(rCBF)均显著增加(P<0.05);相对平均通过时间(rMTT)均显著缩短(P<0.05);但两组术后相对脑血容量(rCBV)及相对达峰时间(rTTP)变化并不明显。28例搭桥患者在术后随访3月到1年均无明显脑出血或脑梗复发,也无新的神经功能恶化,NIHSS评分总分较术前下降。结论::STA-MCA加EDMS是治疗烟雾病和非烟雾病缺血性疾病的有效方式。CT灌注是定量评估术前及术后脑灌注的有效方式

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