中国临床医学影像杂志2025，Vol.36Issue(6)：381-384,4.DOI:10.12117/jccmi.2025.06.001
基于脑CT灌注成像探究脑缺血患者脑血流动力学改变及其临床意义
Exploration on changes and clinical significance of cerebral hemodynamics in patients with cerebral ischemia based on brain CT perfusion imaging
摘要
Abstract
Objective:To explore changes and clinical significance of cerebral hemodynamics in patients with cerebral ischemia based on brain CT perfusion imaging(CTP).Methods:A total of 106 patients with transient ischemic attack(TIA)confirmed in the hospital were enrolled as the research objects from April 2021 to April 2023.All underwent further whole-brain CTP and head-neck CT angiography(CTA)to obtain perfusion parameters(cerebral blood flow(CBF),cerebral blood volume(CBV),mean transit time(MTT),time to peak(TTP))and CTA reconstructed images(volume reconstruction(VR),maximum intensity projection(MIP)).According to the standard of North American symptomatic carotid endarterectomy trial(NASCET),stenosis severity of diseased vessels was evaluated.The relationship between the severity of vascular stenosis and perfusion parameters was analyzed.According to ASPECTS scoring criteria,patients with vascular occlusion were divided into poor collateral circulation group and good collateral circulation group,and perfusion parameters in patients with different collateral circulation were compared.Results:In the 106 patients with TIA,there were 82 cases(77.36%)with 123 abnormal perfusion areas.CBF in abnormal perfusion areas was lower than that in the contralateral mirror area,while TTP and MTT were higher than those in the contralateral mirror area(P<0.05).CTA reconstructed images showed that there were 97 patients(91.51%)with stenosis or occlusion of internal carotid,anterior cerebral artery,middle cerebral artery or posterior cerebral artery,including 11 cases(10.38%)with mild stenosis,25 cases(23.58%)with moderate stenosis,35 cases(33.02%)with severe stenosis,26 cases(24.53%)with occlusion and 9 cases(8.49%)without obvious abnormality.There were significant differences in the severity of vascular stenosis between patients(82 cases)with abnormal cerebral perfusion and those(24 cases)with normal cerebral perfusion(P<0.05).The severity of vascular stenosis was positively correlated with TTP and MTT(P<0.05).Among 26 patients with vascular occlusion,CBF in poor collateral circulation group was lower than that in good collateral circulation group,while TTP and MTT were higher than those in good collateral circulation group(P<0.05).Conclusion:CTP can effectively evaluate changes of cerebral hemodynamics in patients with TIA,which can provide important imaging evidence for TIA evaluation.关键词
脑缺血/体层摄影术,螺旋计算机Key words
Brain Ischemia/Tomography,Spiral Computed分类
医药卫生引用本文复制引用
郑岳林,王心颖,陈碧薇..基于脑CT灌注成像探究脑缺血患者脑血流动力学改变及其临床意义[J].中国临床医学影像杂志,2025,36(6):381-384,4.基金项目
河北省医学科学研究课题计划(编号:20220453). （编号:20220453）
