摘要:
目的:探讨单侧大脑中动脉(MCA)狭窄程度与脑梗死前期CT灌注(CTP)参数的关系,并分析梗死前期血管表面通透性(PS)的变化。方法:回顾性分析我院2018年7月1日至2019年10月1日期间经头颈部CTA诊断单侧MCA狭窄患者108例,观察CTP成像特点,测量各组患侧、镜像侧剩余函数达峰时间(TMax)、平均通过时间(MTT)、脑血流量(CBF)、脑血容量(CBV)以及表面通透性(PS),并计算各灌注参数的相对值(患侧/镜像侧),分析单侧大脑中动脉狭窄程度与脑梗死前期CT灌注参数的相关性。结果:①108例单侧大脑中动脉狭窄患者中39例出现灌注异常,不同程度血管狭窄的灌注分期差异具有统计学意义(P=0.009)。单侧大脑中动脉狭窄程度与灌注异常分期呈中等正相关(r=0.557,P=0.000)。②单侧大脑中动脉不同程度狭窄组间rCBF值、rMTT值差异有统计学意义(P<0.05),而rCBV值、r TMax值差异无统计学意义(P>0.05)。单侧大脑中动脉狭窄程度与rTMax值、rMTT值呈正相关(分别为r=0.458,P=0.003,r=0.765,P=0.000),与rCBF呈负相关相关(r=-0.600,P=0.000),而狭窄程度与rCBV值无明显相关性。③Ⅱa、Ⅱb期患者患侧与镜像侧PS绝对值差异有统计学意义(P<0.05),Ⅱa、Ⅱb期患者组间PS相对值差异没有统计学意义(P>0.05)。结论:单侧MCA狭窄程度与脑梗死前期分期具有一定相关性,单侧MCA狭窄程度越严重,rTMax、rMTT值越大,rCBF越小;在脑梗死前期的II期出现血管表面通透性升高的改变。
Abstract:
Objective:To investigate the relationship between the degree of unilateral middle cerebral artery(MCA) stenosis and CT perfusion(CTP) parameters in the first trimester of cerebral infarction, and to analyze the changes of vascular surface permeability(PS) in the first trimester of infarction. Methods:A total of 108 patients with unilateral middle cerebral artery MCA stenosis diagnosed by head and neck CTA from July 1, 2018 to October 1, 2019 in our hospital were retrospectively analyzed. The imaging characteristics of CTP were observed. The peak time(TMax), mean transit time(MTT), cerebral blood flow(CBF), cerebral blood volume(CBV) and surface permeability(PS) of the residual function of the stenotic and mirror sides in each group were measured, and the relative values of each perfusion parameter(stenotic/mirror side) were calculated. The correlation between the degree of unilateral middle cerebral artery stenosis and CT perfusion parameters in the early stage of cerebral infarction was analyzed. Results:(1) 39 of 108 patients with unilateral middle cerebral artery stenosis had abnormal perfusion, and there was significant difference in perfusion stage of different degrees of vascular stenosis(P=0.009). The degree of unilateral middle cerebral artery stenosis was moderately positively correlated with the stage of abnormal perfusion(r=0.557, P=0.000);(2) There were significant differences in rCBF value and r MTT value of different degrees of unilateral middle cerebral artery stenosis(P<0.05), but there was no significant difference in rCBV value and rTMax value(P>0.05). The degree of unilateral middle cerebral artery stenosis was positively correlated with rTMax values and rMTT values(r=0.458, P=0.003, r=0.765, P=0.000, respectively), negatively correlated with rCBF(r=-0.600, P=0.000), and there was no significant correlation between the degree of stenosis and rCBV values;(3) There was a significant difference in the absolute value of PS between the awn and mirror side in patients with stages IIa and IIb(P<0.05), and there was no significant difference in the relative value of PS between patients with stages IIa and IIb(P>0.05). Conclusion:The degree of unilateral MCA stenosis is related to the degree of unilateral middle cerebral artery stenosis in patients with certain correlation between the degree of unilateral MCA stenosis and the stage of early cerebral infarction. Unilateral TMax is the most sensitive indicator for evaluating the abnormal cerebral perfusion. The more severe the degree of MCA stenosis, the greater the rTMax and rMTT values, the smaller the rCBF; there is a change of increased vascular surface permeability in stage II of early cerebral infarction.
百度学术
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