摘要:
Objective To observe the change of cereberal perfusion parameters in patients with unilateral middle cerebral artery stenosis during a short-term follow-up time.Methods Nineteen of the 35 patients with unilateral middle cerebral artery stenosis who underwent CTP were followed up and divided into moderate stenosis (50%-69%) group (n=10) and severe stenosis (70%-99%) group (n=9) according to their middle cerebral artery stenosis.Their cerebral blood flow (CBF),cerebral volume (CBV),mean transit time (MTT) and time to peak (TTP) were recorded in the interested regions of basal ganglia,corona radiate and centrum semiovale and compared with rCBF,rCBV,rMTT and rTTP in the normal side.The cerebral perfusion parameters before and 3 months after CTP were compared.Results Of the 19 patients with unilateral middle cerebral artery stenosis,7 (36.8%) had improvement in their CTP parameters,7 (36.8%) had no improvement in their CTP parameters,5 (26.3%) were deteriorated in their CTP parameters.The rTTP was longer in 5 pateints and the rCBF was slower in 4 patients.Improvement,no improvement and deterioration were found in 6,3,1 patients of moderate stenosis group and in 1,4,4 patients of severe stenosis group.The rate of improvement was significantly higher in moderate stenosis group than in severe stenosis group (60.0% vs 11.1%,P =0.040).Conclusion CTP parameters will change in patients with symptomatic unilateral symptomatic middle cerebral artery stenosis and improve in some of them during the short-term follow-up time.%目的 观察单侧大脑中动脉狭窄患者脑灌注短期变化.方法 采用CT灌注成像(CTP)检查单侧症状性大脑中动脉狭窄患者35例,有19例完成随访,根据大脑中动脉狭窄程度分为中度狭窄组10例(狭窄率50%~69%)和重度狭窄组9例(狭窄率70%~99%).分别在基底节区,放射冠区、半卵圆中心选择感兴趣区,测量感兴趣区脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)、达峰时间(TTP),将狭窄侧参数值比对侧相对正常侧参数值,即获得各感兴趣区相对灌注参数值(rCBF、rCBV、rMTT、rTTP),3个月后复查CTP,比较CTP前后参数值,并比较2组脑灌注差异.结果 19例患者中,脑CTP参数好转7例(36.8%),无变化7例(36.8%),恶化5例(26.3%),其中rTTP延长5例,rCBF下降4例.中度狭窄组好转、无变化和恶化分别为6、3、1例,重度狭窄组好转、无变化和恶化分别为1、4、4例,2组脑灌注好转变化比较,差异有统计学意义(60.0% vs 11.1%,P=0.040).结论 症状性大脑中动脉狭窄CTP检测脑灌注下降患者短期脑灌注可发生变化,部分患者脑灌注改善.