CTP参数与MCA重度狭窄或闭塞患者脑梗死病情的关系

doi:10.7517/issn.1674-0475.220139

摘要/Abstract

摘要： 本研究探讨CT灌注成像（CTP）参数与大脑中动脉（MCA）重度狭窄或闭塞患者脑梗死病情、侧支循环建立的关系。选取143例MCA重度狭窄或闭塞性脑梗死患者作为研究对象，将患者依据脑梗死发生的病灶大小、病灶部位、侧支循环建立的等级情况分层分析患者的CTP参数，包括脑血流量（CBF）、峰值时间（TTP）、脑血容量（CBV）、平均通过时间（MTT）。分析CTP参数与患者入院后24 h的美国国立卫生研究院卒中量表（NIHSS）评分的关系。MCA重度狭窄或闭塞性脑梗死患者中，大面积脑梗死患者的CBF值低于中等面积脑梗死患者，TTP值大于中等面积脑梗死患者（P<0.05）；侧支循环分级为0～1级患者的CBF、CBV值低于侧支循环分级为2～3级患者，TTP值大于侧支循环分级为2～3级患者（P<0.05）；脑梗死患者病灶梗死核心部位的CBF、CBV、MTT值低于半暗带区域，TTP值大于半暗带区域（P<0.05）；患者的NIHSS评分与CBF呈显著的负相关关系（r=－0.664，P<0.000），与TTP值呈显著正相关关系（r=0.690，P=0.000）；患者的NIHSS评分与CBV、MTT无明显的相关性（P>0.05）。MCA重度狭窄或闭塞患者采用CTP检测，能较好地评价患者梗死病灶大小、侧支循环建立情况及神经功能受损程度。

关键词: CT灌注成像, 大脑中动脉, 重度狭窄, 闭塞, 脑梗死, 侧支循环

Abstract: This study investigated the relationship between CT perfusion imaging (CTP) parameters and cerebral infarction and the establishment of collateral circulation in patients with severe middle cerebral artery (MCA) stenosis or occlusion. 143 patients with severe MCA stenosis or occlusive cerebral infarction were selected as the research subjects. Analyzed the patients' CTP parameters, including cerebral blood flow (CBF), time to peak (TTP), cerebral blood volume (CBV), mean transit time (MTT), according the size of the lesion, the location of the lesion, and the level of collateral circulation established in the patients with cerebral infarction. The relationship between CTP parameters and the National Institutes of Health Stroke Scale (NIHSS) score 24 hours after patients' admission were analyzed. Among the patients with severe MCA stenosis or occlusive cerebral infarction, the CBF value of patients with large-area cerebral infarction was lower than that of patients with moderate-area cerebral infarction, and the TTP value was higher than that of patients with moderate-area cerebral infarction (P<0.05). The CBF and CBV values of patients with collateral circulation grade 0 to 1 were lower than those of patients with collateral circulation grade 2 to 3, and the TTP value was higher than those of patients with collateral circulation grade 2 to 3 (P<0.05). The values of CBF, CBV and MTT in the core of cerebral infarction were lower than those in the penumbra area, and the value of TTP was higher than that in the penumbra area (P<0.05). The patient's NIHSS score was significantly negatively correlated with CBF (r=-0.664, P<0.000) and significantly positively correlated with TTP (r=0.690, P=0.000). There was no significant correlation between NIHSS score and CBV, MTT (P>0.05). CTP can better evaluate the size of infarct focus, the establishment of collateral circulation and the degree of neurological impairment in patients with severe stenosis or occlusion of MCA.

Key words: CT perfusion imaging, middle cerebral artery, severe stenosis, occlusion, cerebral infarction, collateral circulation

邹社昌, 凌容, 张泽微, 文延斌, 郑丽芳. CTP参数与MCA重度狭窄或闭塞患者脑梗死病情的关系[J]. 影像科学与光化学, 2022, 40(4): 741-745.

ZOU Shechang, LING Rong, ZHANG Zewei, WEN Yanbin, ZHENG Lifang. Relationship between CTP Parameters and Cerebral Infarction Condition in Patients with Severe Stenosis or Occlusion of MCA[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(4): 741-745.

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