CT脑灌注参数预测非体外循环下冠状动脉旁路移植术后认知障碍

发布时间：2018-03-09 21:28

本文选题：体层摄影术　切入点：X线计算机　出处：《中国介入影像与治疗学》2015年05期 　论文类型：期刊论文

【摘要】：目的探讨320排动态容积CT脑灌注参数变化对预测非体外循环下冠状动脉旁路移植术(OPCAB)后认知功能障碍(POCD)的价值。方法选择将要接受OPCAB的患者105例,术前进行CT脑灌注检查,手术前后神经系统查体并在术后确认有无POCD的发生。根据术后是否发生POCD分为POCD组和非POCD组,组间进行脑灌注参数单因素分析,根据ROC曲线计算CT脑灌注参数变化率对预测术后POCD发生的最佳截点。结果术后发生POCD发病率为15.24%(16/105)。POCD组与非POCD组的颞叶和额叶局部达峰时间变化率、颞叶局部对比剂平均通过时间变化率、颞叶延迟相变化率差异有统计学意义(P0.05)。颞叶rTTP变化率23%为本研究人群术后发生POCD的最佳截点,可预测术后POCD发生。结论 OPCAB术前接受320排CT脑灌注检查有助于发现术后POCD患者。
[Abstract]:Objective to investigate the value of cerebral perfusion parameters of 320 slice dynamic volume CT in predicting cognitive dysfunction after off-pump coronary artery bypass grafting (OPCAB). Methods 105 patients who were going to receive OPCAB were selected for CT perfusion examination before operation. The nervous system was examined before and after operation and the occurrence of POCD was confirmed after operation. According to the occurrence of POCD after operation, the patients were divided into POCD group and non-#en3# group. The parameters of cerebral perfusion were analyzed by single factor analysis. According to the ROC curve, the best point to predict the occurrence of POCD was calculated by CT perfusion parameters. Results the incidence of POCD after operation was 15.24% and 16 / 105% respectively in the temporal lobe and frontal lobe, and the local peak time change rate in the POCD group and non-POCD group. The mean transit time of temporal lobe contrast agent and the change rate of temporal lobe delayed phase were significantly different (P 0.05). The change rate of rTTP in temporal lobe was 23%, which was the best point of POCD occurrence after operation in this study population. Conclusion 320 slice CT cerebral perfusion examination before OPCAB is helpful to find postoperative POCD patients.
【作者单位】：首都医科大学附属北京安贞医院神经内科;
【基金】：首都医学发展科研基金(2009-2075)
【分类号】：R654.2;R749

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