Application of Quantitative CT Perfusion Imaging in the Diagnosis of Adult Moyamoya Disease
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摘要: 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。Abstract: Objective: To evaluate the application value of computed tomography perfusion(CTP) imaging in the diagnosis of adult Moyamoya disease(MMD). Methods: Fifteen patients with adult MMD confirmed by DSA were selected. CTP were performed in all patients and 10 healthy volunteers. The CTP parameters including cerebral blood flow(CBF), cerebral blood volume(CBV), and mean transit time(MTT) were measured and compared between the MMD group and normal control group. Results: All patients were found abnormal perfusion regions of the brain. CBF and CBV values were significantly lower, and MTT values were obviously higher in the fronto-temporal lobes in the MMD group than normal controls(P < 0.05). In contrast, no significant decrease of CBV value in basal ganglia region was observed in the MMD patients. Conclusion: CTP is a useful method to obtain functional imaging of cerebral microcirculation, which can be a noninvasive assessment of the abnormalities of cerebral perfusion changes in adult MMD before surgery.
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