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目的:单侧颈内动脉(ICA)重度狭窄或闭塞行经颅多普勒(TCD)联合CT灌注成像(CTP)的脑血流动力学评估。方法:选择21例通过TCD检查确诊为单侧ICA重度狭窄或闭塞的患者,根据其病情,分成无症状组(11例)与症状组(10例),两组患者均接受头颅CTA(血管成像)与CTP检测。参照组则为16例健康志愿者。将无症状组及症状组患侧间、无症状组及症状组患侧与参照组的TCD和CTP参数展开对比。结果:TCD表明,相对于参照组,症状组患侧大脑中MCA的血流平均速度更低,无症状组MCA Vm比参照组低,但是数据差异并不存在显著性(P>0.05)。无症状组与症状组的PI(MCA搏动指数)比参照组低(P<0.05)。相较于无症状组,症状组患侧MCA Vm更低,其与颅内侧枝循环存在一定的关联。比较三组CTP参数,发现无症状组的CBF(脑血流量)未发生显著变化(P>0.05),而症状组患侧CBF减少明显(P<0.05)。在平均通过时间与到达峰值时间方面,无症状组与症状组均延长(P<0.05)。而两组的CBV(脑血容量)相对于参照组,并不存在显著差异(P>0.05)。结论:TCD和CTP的检测结果具有较高的一致性,将两种检测手段联合使用,能够更好地对单侧颈动脉狭窄、闭塞患者的脑灌注状况展开全面且综合评定,进而为最佳治疗方案的选择提供相关的依据。
PURPOSE: Cerebral hemodynamic assessment of transcranial Doppler (TCD) combined with CT perfusion imaging (CTP) is performed in patients with severe stenosis or occlusion of unilateral internal carotid artery (ICA). Methods: Twenty-one patients with severe stenosis or occlusion of unilateral ICA diagnosed by TCD were divided into asymptomatic group (n = 11) and symptomatic group (n = 10) according to their condition. All patients underwent cranial CTA ) And CTP detection. The reference group was 16 healthy volunteers. TCD and CTP parameters of the asymptomatic group and the affected group, the asymptomatic group and the affected group and the reference group were compared. Results: TCD showed that compared with the reference group, the mean velocity of MCA in the affected side of the symptom group was lower than that of the reference group, but the difference was not significant (P> 0.05). The PI (MCA pulsatility index) in asymptomatic group and symptom group was lower than that in the reference group (P <0.05). Compared with asymptomatic group, symptom group MCA Vm lower side, which is associated with intracranial collateral circulation. Comparing the CTP parameters of the three groups, we found no significant changes in CBF (cerebral blood flow) in the asymptomatic group (P> 0.05), while the reduction of CBF in the affected group was significant (P <0.05). Asymptomatic and symptomatic groups were prolonged in mean transit time and peak time (P <0.05). There was no significant difference in CBV (cerebral blood volume) between the two groups relative to the reference group (P> 0.05). Conclusion: The results of TCD and CTP have high consistency. The combination of the two detection methods can provide a comprehensive and comprehensive assessment of cerebral perfusion in patients with unilateral carotid artery stenosis and occlusion, which is the best The choice of treatment options provide the relevant basis.