本文選題：腦彩色血流全循環(huán)成像　切入點(diǎn)：血流動力學(xué)　出處：《南方醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：第一部分:彩色血流全循環(huán)成像技術(shù)在正常腦血流動力學(xué)參數(shù)中的研究目的:探討彩色血流全循環(huán)成像技術(shù)(iFlow)在正常腦血流動力學(xué)參數(shù)研究中的價值,以建立正常腦血流動力學(xué)的參數(shù)。方法:回顧性分析中國人民解放軍武漢總醫(yī)院2013年3月至2016年9月顱內(nèi)動脈瘤單純彈簧圈栓塞后入院復(fù)查全腦血管造影(DSA)者及懷疑顱內(nèi)血管疾病最終DSA未見異常者共60例,測量其各感興趣區(qū)(ROI)的造影劑達(dá)峰時間(TTP),將ROI分別設(shè)置為:ROI-1:頸內(nèi)動脈分叉部;ROI-2:大腦中動脈分叉部;ROI-3:上矢狀竇中部;ROI-4:竇匯區(qū);ROI-5:基底動脈末端。結(jié)果:左側(cè)頸內(nèi)動脈造影ROI-1～ROI-4及椎動脈造影ROI-5的達(dá)峰時間分別為(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,右側(cè)頸內(nèi)動脈造影 ROI-1～ROI-4 及椎動脈造影 ROI-5 的達(dá)峰時間分別為(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。結(jié)論:iFlow彩色血流全循環(huán)成像技術(shù)為正常腦血流動力學(xué)參數(shù)提供了一個參考指標(biāo),建立了一種研究腦血流動力學(xué)的新方法。第二部分:彩色血流全循環(huán)成像技術(shù)在中腦周圍非動脈瘤性蛛網(wǎng)膜下腔出血后腦血管痙攣中的研究目的:運(yùn)用彩色血流全循環(huán)成像技術(shù)評估中腦周圍非動脈瘤性蛛網(wǎng)膜下腔出血(PNSAH)后腦血管痙攣的血流動力學(xué)參數(shù)變化。方法:回顧性分析CT檢查結(jié)果和重復(fù)DSA檢查診斷為PNSAH的患者60例為研究組;以顱內(nèi)動脈瘤單純彈簧圈栓塞后半年以上復(fù)查DSA者和懷疑顱內(nèi)血管疾病最終未見異常者共60例為對照組。利用Siemens公司iFlow軟件測量并比較研究組首次造影和復(fù)查造影時雙側(cè)頸內(nèi)動脈分叉部、雙側(cè)大腦中動脈分叉部、雙側(cè)椎動脈造影基底動脈末端相同部位的造影劑TTP及血管直徑,并進(jìn)行統(tǒng)計學(xué)分析。結(jié)果:與對照組相比,首次造影中左椎—基底動脈末端TTP較高,且差異有統(tǒng)計學(xué)意義(p0.05),復(fù)查造影中兩側(cè)椎—基底動脈末端、右側(cè)頸內(nèi)分叉部、右側(cè)大腦中分叉部TTP高于對照組,且差異均有統(tǒng)計學(xué)意義(p0.05),與首次造影相比,復(fù)查造影各部位血流TTP值均增大,基底動脈末端最明顯,差異有統(tǒng)計學(xué)意義(p0.05);與對照組相比,復(fù)查造影兩側(cè)椎—基底動脈末端血管直徑減小,差異有統(tǒng)計學(xué)意義(p0.01),與首次造影相比,復(fù)查造影兩側(cè)椎—基底動脈末端、左側(cè)頸內(nèi)動脈分叉部、左側(cè)大腦中動脈分叉部直徑均減小,差異有統(tǒng)計學(xué)意義(p0.01)。結(jié)論：PNSAH患者出血后存在血管痙攣,且以基底動脈末端較明顯,應(yīng)用iFlow技術(shù)評估腦血管痙攣的結(jié)果可靠而經(jīng)濟(jì)。
[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 鹵0.37 and 2.85 鹵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 鹵0.35 鹵2.87 鹵0.36 鹵8.01 鹵1.14 鹵3.06 鹵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 鹵0.35 鹵0.36 鹵8.01 鹵1.14 鹵3.06 鹵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 鹵0.35 鹵0.36 鹵8.01 鹵1.14 鹵3.06 鹵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 鹵0.35 鹵0.36 鹵8.01 鹵1.14 鹵3.06 鹵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.
【學(xué)位授予單位】：南方醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R651.12

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