摘要
目的：探讨CT灌注（CTP）与磁共振灌注加权成像（PWI）对烟雾病血管重建术疗效的评价价值。方法：收集经DSA证实并行单侧血管重建术的28例烟雾病,均在术前及术后一周内行CTP及PWI检查。获得脑血流量（CBF）、脑血容量（CBV）、平均通过时间（MTT）、达峰时间（TTP）或延迟时间（DT）灌注图,测量手术前后手术侧大脑中动脉（MCA）分布区及同侧小脑对照区的灌注参数值（CBF、CBV、MTT、TTP或DT值）,计算术侧MCA分布区/同侧小脑对照区的灌注参数相对比值（r CBF、r CBV、r MTT、r TTP或r DT值）。采用配对t检验或配对秩和检验比较手术前后CTP及PWI灌注参数相对值的差异,定义P〈0.05时差异有统计学意义。结果：28例烟雾病患者灌注图显示术前手术侧MCA分布区相比对侧出现不同程度的脑血流灌注异常区。烟雾病患者CTP结果显示术后手术侧MCA分布区与小脑对照区的r CBF（1.06±0.35）高于术前r CBF（0.61±0.18）（t值为-4.58,P〈0.05）;术后r CBV1.98（0.71~2.68）高于术前r CBV1.36（0.59~2.34）（z值为-3.05,P〈0.05）;术后r MTT（1.85±0.55）及r TTP（1.08±0.23）明显低于术前的r MTT（2.89±0.57）及r TTP（2.01±0.52）（t值分别为3.96、4.05,P均〈0.05）。PWI结果显示术后手术侧MCA分布区与小脑对照区的r CBF（1.95±0.35）及r CBV（2.31±0.33）高于术前的r CBF（0.86±0.17）及r CBV（1.26±0.30）（t值分别为-3.24、-3.15,P均〈0.05）;术后r MTT（1.16±0.28）及r DT（1.31±0.14）低于术前的r MTT（1.85±0.21）及r DT（3.32±0.45）（t值分别为3.99、4.71,P均〈0.05）。结论：CTP和PWI参数图像能显示脑异常灌注区域,两者均可作为烟雾病血管重建术疗效评价的重要方法。
Purpose： To evaluate the value of CT perfusion （CTP） and perfusion weighted imaging （PWI） in assessment of the effect of cerebral revascularization for Moyamoya disease. Methods： Twenty-eight patients with Moyamoya disease ascertained by digital subtraction angiography （DSA） received cerebral revascularization on one side. CTP and PWI were performed for all patients before and after the operation. The parameter maps of cerebral blood flow （CBF）, cerebral blood volume （CBV）, mean transit time （MTT）, time to peak （TTP） or delay time （DT） were obtained. CBF, CBV, MTT, TTP or DT values were measured in parameters maps at operative side within middle cerebral artery territory and ipsilateral cerebellar hemisphere. Relative perfusion parameter values （rCBF, rCBV, rMTT rTTP or rDT） were calculated. Differences in CTP or PWI values pre- and post- operation were assessed with paired t test or paired rank sum test. Difference would be considered statistically significant if P〈0.05. Results： Preoperative perfusion parameter maps showed that there were different levels of abnormal cerebral blood perfusion area in the operative hemispheres within middle cerebral artery territory in 28 patients. The result of CTP showed that after operation, rCBF （1.06±0.35） of MCA territory on operative side and ipsilateral cerebellar hemisphere were higher than rCBF （0.61±0.18） before operation （t=-4.58, P〈0.05）; rCBV （1.98, 0.71-2.68） after operation were higher than rCBV （1.36, 0.59-2.34） before operation （z=-3.05, P〈0.05）; rMTT （1.85±0.55） and rTTP （1.08±0.23） after operation were lower than rMTT （2.89±0.57） and rTTP （2.01±0.52） before operation （t=3.96, 4.05, P〈0.05）. The result of PWI showed that after operation, rCBF （1.95±0.35） and rCBV （2.31±0.33） of MCA territory on operative side and ipsilateral cerebellar hemisphere were higher than rCBF （0.86±0.17）, rCBV （1.26±0.30） before operation （t=-3.24,-3.15, P〈0.05）; rMTT （1.16±0.28） and, rDT （1.31±0.14） were lower than rMTT （1.85±0.21） and rDT （3.32±0.45） before operation（t=3.99, 4.71, P〈0.05）. Conclusions： Abnormal perfusion area can be shown on CTP and PWI parameter maps, CTP and PWI can be used as an important method for assessment of the effect of cerebral revascularization for Moyamoya disease.
出处
《中国医学计算机成像杂志》
CSCD
北大核心
2015年第1期64-68,共5页
Chinese Computed Medical Imaging
关键词
烟雾病
CT灌注成像
磁共振灌注成像
脑血管重建术
Moyamoya disease
Tomography
X-ray computed
Perfusion imaging
Perfusion weightedimaging
Cerebral revascularization
