本文選題：顱內(nèi)動(dòng)脈瘤 + 灌注��； 參考：《放射學(xué)實(shí)踐》2015年07期

【摘要】：目的:采用全腦CT灌注成像(WB-CTPI)聯(lián)合CT血管成像(CTA)從血管解剖形態(tài)和腦血流動(dòng)力學(xué)方面對(duì)顱內(nèi)動(dòng)脈瘤顯微手術(shù)夾閉和血管內(nèi)介入術(shù)后血管損傷導(dǎo)致的缺血并發(fā)癥進(jìn)行分類和早期診斷。方法:58例顱內(nèi)動(dòng)脈瘤破裂顯微手術(shù)或血管介入術(shù)后出現(xiàn)神經(jīng)功能損傷或臨床懷疑有缺血并發(fā)癥的患者行動(dòng)態(tài)容積CT掃描,并行WB-CTPI和CTA重組。通過CTA評(píng)估父血管或分支血管與血管夾或彈簧圈的關(guān)系。WB-CTPI定量測(cè)量患者患側(cè)與對(duì)側(cè)腦血流動(dòng)力學(xué)參數(shù),采用配對(duì)t檢驗(yàn)進(jìn)行統(tǒng)計(jì)學(xué)分析。結(jié)果:58例患者中,15例經(jīng)WB-CTPI證實(shí)有缺血并發(fā)癥,CTA按血管損傷情況分為:Ⅰ型6例,血管夾或彈簧圈導(dǎo)致父血管狹窄,其中2例CBF降低,CBV降低或正常,4例CBF與CBV正常,6例患者TTP、TTD和MTT均延長(zhǎng);Ⅱ型2例,血管夾導(dǎo)致父血管或分支血管閉塞,CBF和CBV降低,TTP、TTD和MTT延長(zhǎng);Ⅲ型7例,不明原因或無法判斷的血管損傷,CBF降低,CBV降低或正常,TTP、TTD和MTT明顯延長(zhǎng)。結(jié)論:WBCTPI聯(lián)合CTA不僅能夠?qū)ρ軗p傷進(jìn)行分型,還能夠根據(jù)血流動(dòng)力學(xué)損傷情況進(jìn)行腦梗死預(yù)測(cè),指導(dǎo)臨床治療。
[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，

本文編號(hào)：1880597