平板探测器-实质血容量检测评价颈动脉内膜剥脱术围术期脑组织血流灌注

发布时间：2018-01-05 03:33

本文关键词：平板探测器-实质血容量检测评价颈动脉内膜剥脱术围术期脑组织血流灌注　出处：《介入放射学杂志》2016年11期 　论文类型：期刊论文

【摘要】：目的总结分析平板探测器(FPD)-实质血容量(PBV)检测技术在颈动脉内膜剥脱术(CEA)患者围术期脑组织灌注评价中应用的可行性及临床价值。方法连续收治的40例明确诊断为单侧症状性颈内动脉重度狭窄(70%~99%)患者均经复合手术室头颈部经颅多普勒超声和(或)全脑DSA评估并接受CEA手术,术前、术后即刻作FPD-PBV检测,评估脑组织血流灌注变化。结果 FPD-PBV技术可很好地检测CEA围术期患者脑组织血流灌注。40例患者均为单侧症状性颈内动脉起始段重度狭窄(左侧18例,右侧22例),术前患侧脑血流灌注明显低于健侧(P0.05)。顺利完成CEA术后DSA显示颈内动脉再通良好,颅内分支血流恢复,患侧脑血流灌注较术前增加(P0.05),其中22例术后脑灌注改善,但仍低于健侧(10%);15例高于健侧(5%);3例与健侧相等。术后患侧和健侧脑灌注间差异无统计学意义(P0.05)。结论 FPD-PBV检测是一种可行的、有较高临床应用价值的成像技术,可用于半定量分析脑灌注变化,为围术期治疗决策和疗效评价提供更多有价值信息。
[Abstract]:Objective to summarize and analyze the detection technique of flat-plate detector FPD-parenchymal blood volume (PBV) in carotid endarterectomy (carotid endarterectomy). Feasibility and clinical value of perioperative cerebral perfusion evaluation methods 40 consecutive patients with unilateral symptomatic severe stenosis of the internal carotid artery were diagnosed as severe stenosis of the internal carotid artery. All the patients were evaluated by transcranial Doppler ultrasound and / or whole brain DSA in the combined operating room and underwent CEA operation. FPD-PBV was detected immediately before and after operation. Results FPD-PBV technique could be used to detect the cerebral blood perfusion in patients with CEA during perioperative period. All the 40 patients were severe stenosis of unilateral symptomatic internal carotid artery (1). Left 18 cases. The cerebral blood flow perfusion in the right side of 22 cases was significantly lower than that in the normal side (P 0.05). DSA showed that the internal carotid artery was recanalized well and the blood flow of the intracranial branches recovered after CEA. The cerebral blood flow perfusion in the affected side was significantly higher than that before operation (P 0.05). The cerebral perfusion was improved in 22 cases after operation, but it was still lower than that in the normal side. 15 cases were higher than that of healthy side. There was no significant difference in cerebral perfusion between the affected side and the healthy side after operation (P 0.05). Conclusion FPD-PBV is a feasible imaging technique with high clinical application value. It can be used for semi-quantitative analysis of cerebral perfusion changes and provide more valuable information for perioperative treatment decision and evaluation of curative effect.
【作者单位】：首都医科大学宣武医院介入治疗科;
【分类号】：R743.3
【正文快照】： 脑血管病占我国乃至全世界最常见致死和成人致残原因的第二位[1]。颈动脉粥样硬化性狭窄是引起缺血性脑卒中的主要原因之一。颈动脉内膜剥脱术(carotid endarterectomy,CEA)已被认为是治疗颈动脉重度狭窄的最有效方法[2]。由于患者脑循环调节代偿能力差异,CEA术后缺血脑组织血

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