脑动静脉畸形的脑灌注特征及栓塞治疗对脑灌注影响的影像学研究

发布时间：2018-03-20 22:21

本文选题：脑动静脉畸形　切入点：栓塞治疗　出处：《昆明医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：[目的]观测脑动静脉畸形(BAVM)栓塞治疗前后各时期脑灌注的变化。根据脑灌注变化情况寻求针对性临床治疗措施,降低并发症发生率。[方法]回顾性分析21例行BAVM栓塞术患者资料,所有患者于术前3天内、术后经ICU监护平稳过渡且血压平稳后、术后3～6个月复查时行脑MR PWI检查。通过对区域脑血流量(rCBF)、区域脑血容量(rCBV)、区域平均通过时间(rMTT)及区域达峰时间(rTTP)的检测,了解患者各时期脑灌注变化情况,探究如何改善临床治疗。[结果]栓塞术前BAVM供血动脉的供血区域内rCBF、rCBV较健侧半球低,rMTT时间延长;术后ICU监护结束时患侧rCBF、rCBV较健侧增高,rMTT时间缩短;术后3～6个月复查时健患侧脑血流灌注参数无明显差异。[结论]MR PWI检查可观测BAVM栓塞术引起的脑灌注变化,可为改善治疗提供依据。栓塞术引起的脑灌注变化为短期的改变,最终患侧脑灌注趋于正常。临床需重点防治正常灌注压突破(NPPB)导致的并发症。
[Abstract]:[objective] to observe the changes of cerebral perfusion before and after cerebral arteriovenous malformation (BAVM) embolization. To reduce the incidence of complications. [methods] 21 patients with BAVM embolization were retrospectively analyzed. All patients underwent ICU monitoring and stable blood pressure within 3 days before operation. The regional cerebral blood flow (rCBF), regional cerebral blood volume (rCBV), regional mean transit time (rMTT) and regional peak time (rTTP) were measured at 3 ~ 6 months after operation. To explore how to improve the clinical treatment. [results] before embolization, the time of rCBFU rCBV in the blood supply area of BAVM was longer than that in the normal hemispheres, and the time of rCBFV in the affected side was shorter than that in the normal side at the end of ICU monitoring. There was no significant difference in cerebral perfusion parameters between 3 ~ 6 months after operation. [conclusion] Mr PWI can be used to observe the changes of cerebral perfusion induced by BAVM embolization, and to provide evidence for the improvement of treatment. The changes of cerebral perfusion caused by embolization are short-term changes. In the end, the cerebral perfusion of the affected side tended to be normal, and the complications caused by the breakthrough of normal perfusion pressure (NPPB) should be prevented and treated clinically.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.4;R445.2

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