全脑CT灌注成像联合CT血管成像评估动脉瘤夹闭和血管内介入术后缺血并发症

发布时间：2018-05-12 23:20

  本文选题：颅内动脉瘤 + 灌注　； 参考：《放射学实践》2015年07期

【摘要】：目的:采用全脑CT灌注成像(WB-CTPI)联合CT血管成像(CTA)从血管解剖形态和脑血流动力学方面对颅内动脉瘤显微手术夹闭和血管内介入术后血管损伤导致的缺血并发症进行分类和早期诊断。方法:58例颅内动脉瘤破裂显微手术或血管介入术后出现神经功能损伤或临床怀疑有缺血并发症的患者行动态容积CT扫描,并行WB-CTPI和CTA重组。通过CTA评估父血管或分支血管与血管夹或弹簧圈的关系。WB-CTPI定量测量患者患侧与对侧脑血流动力学参数,采用配对t检验进行统计学分析。结果:58例患者中,15例经WB-CTPI证实有缺血并发症,CTA按血管损伤情况分为:Ⅰ型6例,血管夹或弹簧圈导致父血管狭窄,其中2例CBF降低,CBV降低或正常,4例CBF与CBV正常,6例患者TTP、TTD和MTT均延长;Ⅱ型2例,血管夹导致父血管或分支血管闭塞,CBF和CBV降低,TTP、TTD和MTT延长;Ⅲ型7例,不明原因或无法判断的血管损伤,CBF降低,CBV降低或正常,TTP、TTD和MTT明显延长。结论:WBCTPI联合CTA不仅能够对血管损伤进行分型,还能够根据血流动力学损伤情况进行脑梗死预测,指导临床治疗。
[Abstract]:Objective: using WB-CTPI (whole brain CT perfusion imaging) combined with CT angiography (CTAA) to study the ischemic complications caused by microsurgical clipping of intracranial aneurysms and vascular injury after intravascular intervention from the aspects of vascular anatomy and cerebral hemodynamics. Classification and early diagnosis were performed. Methods 58 cases of intracranial aneurysm ruptured by microsurgery or vascular intervention were performed dynamic volume CT scan, WB-CTPI and CTA recombination. WB-CTPI was used to quantitatively measure the hemodynamic parameters of the affected and contralateral cerebral hemodynamics of the patients, and the paired t test was used to analyze the relationship between the parent or branch vessels and the clasp or coil. Results among 58 cases, 15 cases had ischemic complications confirmed by WB-CTPI. According to the vascular injury, 6 cases were type 鈪，

本文编号：1880597