本文選題：煙霧病　切入點(diǎn)：CT灌注成像　出處：《中國(guó)醫(yī)學(xué)計(jì)算機(jī)成像雜志》2015年01期 　論文類型：期刊論文

【摘要】：目的:探討CT灌注(CTP)與磁共振灌注加權(quán)成像(PWI)對(duì)煙霧病血管重建術(shù)療效的評(píng)價(jià)價(jià)值。方法:收集經(jīng)DSA證實(shí)并行單側(cè)血管重建術(shù)的28例煙霧病,均在術(shù)前及術(shù)后一周內(nèi)行CTP及PWI檢查。獲得腦血流量(CBF)、腦血容量(CBV)、平均通過時(shí)間(MTT)、達(dá)峰時(shí)間(TTP)或延遲時(shí)間(DT)灌注圖,測(cè)量手術(shù)前后手術(shù)側(cè)大腦中動(dòng)脈(MCA)分布區(qū)及同側(cè)小腦對(duì)照區(qū)的灌注參數(shù)值(CBF、CBV、MTT、TTP或DT值),計(jì)算術(shù)側(cè)MCA分布區(qū)/同側(cè)小腦對(duì)照區(qū)的灌注參數(shù)相對(duì)比值(r CBF、r CBV、r MTT、r TTP或r DT值)。采用配對(duì)t檢驗(yàn)或配對(duì)秩和檢驗(yàn)比較手術(shù)前后CTP及PWI灌注參數(shù)相對(duì)值的差異,定義P0.05時(shí)差異有統(tǒng)計(jì)學(xué)意義。結(jié)果:28例煙霧病患者灌注圖顯示術(shù)前手術(shù)側(cè)MCA分布區(qū)相比對(duì)側(cè)出現(xiàn)不同程度的腦血流灌注異常區(qū)。煙霧病患者CTP結(jié)果顯示術(shù)后手術(shù)側(cè)MCA分布區(qū)與小腦對(duì)照區(qū)的r CBF(1.06±0.35)高于術(shù)前r CBF(0.61±0.18)(t值為-4.58,P0.05);術(shù)后r CBV1.98(0.71~2.68)高于術(shù)前r CBV1.36(0.59~2.34)(z值為-3.05,P0.05);術(shù)后r MTT(1.85±0.55)及r TTP(1.08±0.23)明顯低于術(shù)前的r MTT(2.89±0.57)及r TTP(2.01±0.52)(t值分別為3.96、4.05,P均0.05)。PWI結(jié)果顯示術(shù)后手術(shù)側(cè)MCA分布區(qū)與小腦對(duì)照區(qū)的r CBF(1.95±0.35)及r CBV(2.31±0.33)高于術(shù)前的r CBF(0.86±0.17)及r CBV(1.26±0.30)(t值分別為-3.24、-3.15,P均0.05);術(shù)后r MTT(1.16±0.28)及r DT(1.31±0.14)低于術(shù)前的r MTT(1.85±0.21)及r DT(3.32±0.45)(t值分別為3.99、4.71,P均0.05)。結(jié)論:CTP和PWI參數(shù)圖像能顯示腦異常灌注區(qū)域,兩者均可作為煙霧病血管重建術(shù)療效評(píng)價(jià)的重要方法。
[Abstract]:Objective: to evaluate the efficacy of CT perfusion imaging (CTP) and magnetic resonance perfusion weighted imaging (Mr PWI) in the treatment of moyamoya disease. Methods: 28 cases of moyamoya disease confirmed by DSA and underwent unilateral vessel reconstruction were collected. Cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), peak time (TTP) or delayed time (DTT) perfusion were obtained. Before and after operation, the perfusion parameters of the MCA area of the middle cerebral artery and the ipsilateral cerebellar control area were measured. The ratio of the perfusion parameters of the MCA distribution area to the ipsilateral cerebellar control area was calculated, and the ratio of the perfusion parameters of the MCA distribution area to the ipsilateral cerebellar control area was calculated, and the ratio of the perfusion parameters to the MCA / ipsilateral cerebellar control area was calculated. The relative values of CTP and PWI perfusion parameters before and after operation were compared by paired t test or paired rank sum test. Results the perfusion map of 28 patients with moyamoya disease showed different degree of cerebral blood perfusion abnormality than that of the other side. The CTP results of the patients with moyamoya disease showed the postoperative operation. R CBF(1.06 鹵0.35 in the MCA distribution area and the cerebellar control area was higher than that in the preoperative r CBF(0.61 鹵0.18 t value (-4.58) P 0.05; the postoperative r CBV 1.980.71 鹵2.68) was higher than the preoperative r CBV1.36(0.59~2.34)(z value of -3.05% P0.05; the postoperative r MTT(1.85 鹵0.55) and r TTP(1.08 鹵0.23) were significantly lower than those of the preoperative r MTT(2.89 鹵0.57) and the r TTP(2.01 鹵0.52 t values were 3.96 鹵4.05 (P < 0.05) and 0.05% respectively. The results showed that the postoperative r MTT(1.85 鹵0.55) and r TTP(1.08 鹵0.23) were significantly lower than those of the preoperative r MTT(2.89 鹵0.57) and the r TTP(2.01 鹵0.52 t values were 3.96 鹵4.05 (P < 0.05). The values of r CBF(1.95 鹵0.35 and r CBV(2.31 鹵0.33 in the MCA distribution area and the cerebellar control area were higher than those in the preoperative r CBF(0.86 鹵0.17) and r CBV(1.26 鹵0.30 (P < 0.05); r MTT(1.16 鹵0.28) and r DT(1.31 鹵0.14) were lower than those before the operation (r MTT(1.85 鹵0.21) and r DT(3.32 鹵0.45 鹵4.71 (P < 0.05). Conclusion\\\%\% MTT(1.16 鹵0. 28) and r DT(1.31 鹵0\ ^ 14) were lower than those before operation (r MTT(1.85 鹵0. 21) and r DT(3.32 鹵0. 45 t (P < 0. 05). Conclusion\% CTP and PWI parameters can be shown. Abnormal brain perfusion area, Both of them can be used as an important method to evaluate the effect of angioplasty for moyamoya disease.
【作者單位】： 上海市第一人民醫(yī)院寶山分院放射科;復(fù)旦大學(xué)附屬華山醫(yī)院放射科;
【分類號(hào)】：R651.12;R816.1;R445.2

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