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目的:探讨多层螺旋CT灌注检查在成人型烟雾病(MMD)患者诊治中的应用价值。方法:收集经DSA证实的MMD患者15例,所有患者均接受CT灌注检查。测量病变区额叶、颞叶及基底节区域脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT),并与10例对照组的脑灌注参数进行比较。结果:15例患者均发现异常灌注脑区,与对照组比较,患者组额叶、颞叶CBF、CBV降低、MTT延长,差异具有显著统计学意义(P<0.05)。基底节区CBF减低,MTT延迟,而CBV与对照组无明显差别。结论:CT灌注成像不仅有助于判断成人型MMD脑缺血的部位及程度,而且能为临床医生选择适当的手术时机和最佳术式提供客观依据。
Objective: To investigate the value of multislice spiral CT perfusion in diagnosis and treatment of adult moyamoya disease (MMD). Methods: Fifteen patients with MMD confirmed by DSA were collected. All patients underwent CT perfusion examination. Cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) of frontal lobe, temporal lobe and basal ganglia were measured and compared with the cerebral perfusion parameters of 10 control subjects. Results: All of the 15 patients had abnormal brain perfusion. Compared with the control group, the CBF and CBV in the frontal lobe and the temporal lobe of the patients decreased and the MTT prolonged. The difference was statistically significant (P <0.05). CBF decreased basal ganglia, MTT delay, while CBV and control group no significant difference. Conclusion: CT perfusion imaging can not only help determine the location and degree of cerebral ischemia in adult MMD, but also provide an objective basis for clinicians to choose the appropriate operation timing and the best surgical procedures.