彩色血流全循环成像技术在脑血流动力学评估中的应用

发布时间：2018-03-03 21:59

本文选题：脑彩色血流全循环成像　切入点：血流动力学　出处：《南方医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：第一部分:彩色血流全循环成像技术在正常脑血流动力学参数中的研究目的:探讨彩色血流全循环成像技术(iFlow)在正常脑血流动力学参数研究中的价值,以建立正常脑血流动力学的参数。方法:回顾性分析中国人民解放军武汉总医院2013年3月至2016年9月颅内动脉瘤单纯弹簧圈栓塞后入院复查全脑血管造影(DSA)者及怀疑颅内血管疾病最终DSA未见异常者共60例,测量其各感兴趣区(ROI)的造影剂达峰时间(TTP),将ROI分别设置为:ROI-1:颈内动脉分叉部;ROI-2:大脑中动脉分叉部;ROI-3:上矢状窦中部;ROI-4:窦汇区;ROI-5:基底动脉末端。结果:左侧颈内动脉造影ROI-1～ROI-4及椎动脉造影ROI-5的达峰时间分别为(2.70±0.37)s、(2.85±0.36)s、(7.98± 1.54)s、(8.85±1.77)s、(3.02±0.58)s,右侧颈内动脉造影 ROI-1～ROI-4 及椎动脉造影 ROI-5 的达峰时间分别为(2.77±0.35)s、(2.87±0.36)s、(8.01±1.14)s、(8.77±1.26)s、(3.06±0.55)s。结论:iFlow彩色血流全循环成像技术为正常脑血流动力学参数提供了一个参考指标,建立了一种研究脑血流动力学的新方法。第二部分:彩色血流全循环成像技术在中脑周围非动脉瘤性蛛网膜下腔出血后脑血管痉挛中的研究目的:运用彩色血流全循环成像技术评估中脑周围非动脉瘤性蛛网膜下腔出血(PNSAH)后脑血管痉挛的血流动力学参数变化。方法:回顾性分析CT检查结果和重复DSA检查诊断为PNSAH的患者60例为研究组;以颅内动脉瘤单纯弹簧圈栓塞后半年以上复查DSA者和怀疑颅内血管疾病最终未见异常者共60例为对照组。利用Siemens公司iFlow软件测量并比较研究组首次造影和复查造影时双侧颈内动脉分叉部、双侧大脑中动脉分叉部、双侧椎动脉造影基底动脉末端相同部位的造影剂TTP及血管直径,并进行统计学分析。结果:与对照组相比,首次造影中左椎—基底动脉末端TTP较高,且差异有统计学意义(p0.05),复查造影中两侧椎—基底动脉末端、右侧颈内分叉部、右侧大脑中分叉部TTP高于对照组,且差异均有统计学意义(p0.05),与首次造影相比,复查造影各部位血流TTP值均增大,基底动脉末端最明显,差异有统计学意义(p0.05);与对照组相比,复查造影两侧椎—基底动脉末端血管直径减小,差异有统计学意义(p0.01),与首次造影相比,复查造影两侧椎—基底动脉末端、左侧颈内动脉分叉部、左侧大脑中动脉分叉部直径均减小,差异有统计学意义(p0.01)。结论：PNSAH患者出血后存在血管痉挛,且以基底动脉末端较明显,应用iFlow技术评估脑血管痉挛的结果可靠而经济。
[Abstract]:The first part: the study of color blood flow imaging in normal cerebral hemodynamic parameters objective: to study the value of color blood flow imaging in the study of normal cerebral hemodynamic parameters. Methods: to establish the parameters of normal cerebral hemodynamics. Methods: the patients with DSAs were retrospectively analyzed after embolization of intracranial aneurysms with simple coil from March 2013 to September 2016 in Wuhan General Hospital of the Chinese people's Liberation Army, and. There were 60 cases of suspected intracranial vascular disease without DSA abnormality. The ROI was set as: 1: 1: the bifurcation of the internal carotid artery, ROI-2: middle cerebral artery bifurcation, ROI-3: central superior sagittal sinus, ROI-4: sinus confluence region: end of basilar artery. Results: left internal carotid artery, left internal carotid artery, caudal part of the left internal carotid artery, roi 3: central part of the superior sagittal sinus, ROI-4: sinus confluence region: end of basilar artery. Results: left internal carotid artery. The peak time of ROI-1~ROI-4 and ROI-5 were 2.70 卤0.37 and 2.85 卤0.36, respectively. Conclusion the peak time of right internal carotid arteriography (ROI-1~ROI-4) and vertebral arteriography ROI-5 (ROI-5) is 2.77 卤0.35 卤2.87 卤0.36 卤8.01 卤1.14 卤3.06 卤0.55 s respectively. Conclusion the peak time of right internal carotid artery angiography (ROI-1~ROI-4) and vertebral arteriography ROI-5 (ROI-5) is 2.77 卤0.35 卤0.36 卤8.01 卤1.14 卤3.06 卤0.55s.Conclusion the peak time of right internal carotid artery angiography (ROI-1~ROI-4) and vertebral arteriography ROI-5 (ROI-5) is 2.77 卤0.35 卤0.36 卤8.01 卤1.14 卤3.06 卤0.55s.Conclusion the peak time of right internal carotid artery angiography (ROI-1~ROI-4) and vertebral arteriography ROI-5 (ROI-5) is 2.77 卤0.35 卤0.36 卤8.01 卤1.14 卤3.06 卤0.55 s respectively. Parameter provides a reference indicator, A new method for the study of cerebral hemodynamics was established. Part 2: color blood flow imaging in cerebral vasospasm after non-aneurysm subarachnoid hemorrhage objective: to apply color blood flow in cerebral vasospasm after non-aneurysm subarachnoid hemorrhage. The hemodynamic parameters of cerebral vasospasm after non-aneurysm subarachnoid hemorrhage (PNSAH) were evaluated by total circulatory imaging. Methods: the results of CT and 60 cases of PNSAH diagnosed by repeated DSA were analyzed retrospectively in the study group. A total of 60 patients with DSA and 60 patients with suspected intracranial vascular disease were treated as control group after embolization of intracranial aneurysm with simple coils for more than six months. The results were measured by iFlow software of Siemens Company and compared with the first angiography and reexamination in the study group. The bifurcation of bilateral internal carotid artery, The TTP and diameter of contrast agent at the same end of basilar artery in bilateral middle cerebral artery and bilateral vertebral arteriography were analyzed statistically. Results: compared with the control group, the TTP at the end of left vertebrobasilar artery in the first angiography was higher than that in the control group. The difference was statistically significant (P 0.05). The TTP of the bilateral vertebrobasilar artery, the right cervical internal bifurcation and the right middle cerebral bifurcation were significantly higher than those of the control group, and the difference was statistically significant compared with that of the first contrast radiography. The TTP value of blood flow increased in all parts of angiography, the most obvious difference was at the end of basilar artery, the difference was statistically significant (p 0.05), compared with the control group, the diameter of blood vessels at the end of vertebrobasilar artery in both sides of the angiography was smaller than that in the control group. The difference was statistically significant (p 0.01). Compared with the first angiography, the diameters of the branches of the left internal carotid artery and the left middle cerebral artery were decreased in the end of the vertebrobasilar artery, the left internal carotid artery and the left middle cerebral artery. Conclusion there is vasospasm in the patients with iFlow after hemorrhage, and the end of the basilar artery is more obvious. The result of iFlow in evaluating cerebral vasospasm is reliable and economical.
【学位授予单位】：南方医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R651.12

【参考文献】