CT灌注与MR灌注加权成像对烟雾病血管重建术疗效的评价

发布时间：2018-03-07 19:41

本文选题：烟雾病　切入点：CT灌注成像　出处：《中国医学计算机成像杂志》2015年01期 　论文类型：期刊论文

【摘要】：目的:探讨CT灌注(CTP)与磁共振灌注加权成像(PWI)对烟雾病血管重建术疗效的评价价值。方法:收集经DSA证实并行单侧血管重建术的28例烟雾病,均在术前及术后一周内行CTP及PWI检查。获得脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)、达峰时间(TTP)或延迟时间(DT)灌注图,测量手术前后手术侧大脑中动脉(MCA)分布区及同侧小脑对照区的灌注参数值(CBF、CBV、MTT、TTP或DT值),计算术侧MCA分布区/同侧小脑对照区的灌注参数相对比值(r CBF、r CBV、r MTT、r TTP或r DT值)。采用配对t检验或配对秩和检验比较手术前后CTP及PWI灌注参数相对值的差异,定义P0.05时差异有统计学意义。结果:28例烟雾病患者灌注图显示术前手术侧MCA分布区相比对侧出现不同程度的脑血流灌注异常区。烟雾病患者CTP结果显示术后手术侧MCA分布区与小脑对照区的r CBF(1.06±0.35)高于术前r CBF(0.61±0.18)(t值为-4.58,P0.05);术后r CBV1.98(0.71~2.68)高于术前r CBV1.36(0.59~2.34)(z值为-3.05,P0.05);术后r MTT(1.85±0.55)及r TTP(1.08±0.23)明显低于术前的r MTT(2.89±0.57)及r TTP(2.01±0.52)(t值分别为3.96、4.05,P均0.05)。PWI结果显示术后手术侧MCA分布区与小脑对照区的r CBF(1.95±0.35)及r CBV(2.31±0.33)高于术前的r CBF(0.86±0.17)及r CBV(1.26±0.30)(t值分别为-3.24、-3.15,P均0.05);术后r MTT(1.16±0.28)及r DT(1.31±0.14)低于术前的r MTT(1.85±0.21)及r DT(3.32±0.45)(t值分别为3.99、4.71,P均0.05)。结论:CTP和PWI参数图像能显示脑异常灌注区域,两者均可作为烟雾病血管重建术疗效评价的重要方法。
[Abstract]:Objective: to evaluate the efficacy of CT perfusion imaging (CTP) and magnetic resonance perfusion weighted imaging (Mr PWI) in the treatment of moyamoya disease. Methods: 28 cases of moyamoya disease confirmed by DSA and underwent unilateral vessel reconstruction were collected. Cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), peak time (TTP) or delayed time (DTT) perfusion were obtained. Before and after operation, the perfusion parameters of the MCA area of the middle cerebral artery and the ipsilateral cerebellar control area were measured. The ratio of the perfusion parameters of the MCA distribution area to the ipsilateral cerebellar control area was calculated, and the ratio of the perfusion parameters of the MCA distribution area to the ipsilateral cerebellar control area was calculated, and the ratio of the perfusion parameters to the MCA / ipsilateral cerebellar control area was calculated. The relative values of CTP and PWI perfusion parameters before and after operation were compared by paired t test or paired rank sum test. Results the perfusion map of 28 patients with moyamoya disease showed different degree of cerebral blood perfusion abnormality than that of the other side. The CTP results of the patients with moyamoya disease showed the postoperative operation. R CBF(1.06 卤0.35 in the MCA distribution area and the cerebellar control area was higher than that in the preoperative r CBF(0.61 卤0.18 t value (-4.58) P 0.05; the postoperative r CBV 1.980.71 卤2.68) was higher than the preoperative r CBV1.36(0.59~2.34)(z value of -3.05% P0.05; the postoperative r MTT(1.85 卤0.55) and r TTP(1.08 卤0.23) were significantly lower than those of the preoperative r MTT(2.89 卤0.57) and the r TTP(2.01 卤0.52 t values were 3.96 卤4.05 (P < 0.05) and 0.05% respectively. The results showed that the postoperative r MTT(1.85 卤0.55) and r TTP(1.08 卤0.23) were significantly lower than those of the preoperative r MTT(2.89 卤0.57) and the r TTP(2.01 卤0.52 t values were 3.96 卤4.05 (P < 0.05). The values of r CBF(1.95 卤0.35 and r CBV(2.31 卤0.33 in the MCA distribution area and the cerebellar control area were higher than those in the preoperative r CBF(0.86 卤0.17) and r CBV(1.26 卤0.30 (P < 0.05); r MTT(1.16 卤0.28) and r DT(1.31 卤0.14) were lower than those before the operation (r MTT(1.85 卤0.21) and r DT(3.32 卤0.45 卤4.71 (P < 0.05). Conclusion\\\%\% MTT(1.16 卤0. 28) and r DT(1.31 卤0\ ^ 14) were lower than those before operation (r MTT(1.85 卤0. 21) and r DT(3.32 卤0. 45 t (P < 0. 05). Conclusion\% CTP and PWI parameters can be shown. Abnormal brain perfusion area, Both of them can be used as an important method to evaluate the effect of angioplasty for moyamoya disease.
【作者单位】：上海市第一人民医院宝山分院放射科;复旦大学附属华山医院放射科;
【分类号】：R651.12;R816.1;R445.2

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