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目的分析颅内动脉重度狭窄或闭塞后脑组织血流灌注情况,并评估预后。方法收集海军总医院神经内科2014年3月—2015年11月收治的25例单侧或双侧颅内动脉重度狭窄或闭塞患者,男性14例、女性11例,年龄22~71岁。所有患者经数字减影脑血管造影(digital subtraction angiography,DSA)或CT血管造影确诊,99mTc-双半胱乙酯单光子发射型计算机断层扫描完成脑血流灌注显像,分析患者一般临床特点及影像学资料。结果经DSA发现颅脑已建立侧支循环代偿供血系统13例。单侧皮质区血流灌注局限性减低22例,其中伴单侧基底节区血流轻度减低10例、伴单侧小脑灌注减低3例、伴单侧丘脑灌注减低9例;未见异常3例。入院时美国国立卫生研究院卒中量表评分平均1.2分,经治疗后美国国立卫生研究院卒中量表评分平均0.5分。结论采用单光子发射型计算机断层扫描脑血流灌注显像可有效评估颅内血管重度狭窄或闭塞后的局部脑动脉血流灌注,安全有效,尤其有助于进一步评估DSA检查未见局部代偿血管形成患者的脑组织血流灌注。
Objective To analyze the perfusion of brain tissue after severe stenosis or occlusion of intracranial artery and evaluate the prognosis. Methods Twenty-five patients with severe stenosis or occlusion of unilateral or bilateral intracranial arteries were enrolled in Department of Neurology, Naval General Hospital from March 2014 to November 2015. There were 14 males and 11 females, aged 22-71 years. All patients were diagnosed by digital subtraction angiography (DSA) or CT angiography. 99mTc-BCC single photon emission computed tomography was used to complete cerebral perfusion imaging. The clinical features of the patients were analyzed. Imaging information. Results DSA found that the brain has established 13 cases of collateral circulation compensatory blood supply system. The limitations of perfusion in unilateral cortical area were reduced in 22 cases, with a slight decrease of blood flow in unilateral basal ganglia in 10 cases, unilateral cerebellar perfusion in 3 cases, unilateral thalamic perfusion in 9 cases, and no abnormality in 3 example. On admission, the National Institutes of Health Stroke Scale scored an average of 1.2 points, with an average of 0.5 points on the NIH Stroke Scale score after treatment. Conclusions Single photon emission computed tomography perfusion imaging is a safe and effective method for assessing intracranial arterial perfusion after severe intracranial stenosis or occlusion. It is especially helpful for further assessment of DSA Blood flow perfusion in brain tissue of patients with angiogenesis.