氙CT指导脑血运重建术治疗症状性前循环动脉狭窄及闭塞

发布时间：2018-03-31 23:22

本文选题：动脉粥样硬化性狭窄　切入点：脑动脉闭塞　出处：《中国脑血管病杂志》2017年05期

【摘要】：目的探讨氙CT脑血流灌注成像技术在脑血运重建术前及疗效评估中的作用。方法回顾性分析15例症状性前循环供血动脉粥样硬化性狭窄或闭塞患者的临床资料,其中行血管内支架置入术8例、颈内动脉内膜切除术1例和颞浅动脉-大脑中动脉旁路移植术6例,对比术前与术后2周内氙CT检测的局部脑血流量(r CBF)及术后6个月改良Rankin量表(mRS)评分。结果 (1)12例术前靶血管远端血流灌注异常患者平均r CBF值为(30±10)ml/(100 g·min),术后为(32±14)ml/(100 g·min),与术前比较差异有统计学意义(P=0.044);3例术前靶血管远端血流灌注正常患者平均r CBF值为(48±6)ml/(100 g·min),术后平均r CBF值为(50±7)ml/(100 g·min),与术前比较差异无统计学意义(P0.05)。(2)术后mRS评分改善8例,稳定7例。15例患者术后mRS评分为[1(0,3)]分,与术前[3(1,3)]分比较,差异有统计学意义(P0.05)。随访期间无一例新发神经功能障碍。结论血运重建术可改善术前存在血流动力学障碍的症状性前循环供血动脉狭窄或闭塞患者的靶血管远端局部脑血流灌注及神经功能缺损症状,而术前氙CT脑血流灌注成像灌注异常可能较灌注正常患者获益更多。
[Abstract]:Objective to investigate the role of xenon CT perfusion imaging before and after cerebral revascularization. Methods the clinical data of 15 patients with symptomatic anterior circulation stenosis or occlusion were retrospectively analyzed. Among them, 8 cases underwent endovascular stenting, 1 case underwent internal carotid endarterectomy and 6 cases received superficial temporal arterial-middle cerebral artery bypass grafting. The regional cerebral blood flow (rCBF) measured by xenon CT and the score of modified Rankin scale mRS6 months after operation were compared. Results the mean r CBF value of 12 patients with abnormal blood perfusion at the distal end of target blood vessel before and after operation was 30 卤10)ml/(100 / min and 32 卤14)ml/(100 / min, respectively. The mean r CBF value of 3 patients with normal blood flow perfusion at the distal end of target vessel before operation was 48 卤6)ml/(100 g / min, and the mean r CBF value was 50 卤7)ml/(100 g / min after operation. There was no significant difference between before and after operation (P 0. 05 卤0. 05 g / min) mRS score was improved in 8 cases after operation, and there was no significant difference between before and after operation (P 0. 05 卤0. 05%, P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05%). The mRS score of 7 cases (15 cases) of stable patients after operation was [1 0 0 3], which was compared with that of preoperative [31% 3]. No new neurological dysfunction was found during follow-up. Conclusion revascularization can improve the distance of target vessels in patients with symptomatic anterior circulation stenosis or occlusion with hemodynamic disorders before operation. Regional cerebral blood perfusion and neurological deficit symptoms, Preoperative xenon CT perfusion perfusion may be more beneficial than normal perfusion.
【作者单位】：广东省中医院神经外科;
【分类号】：R651.12

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