CTP与CTA诊断颈动脉狭窄性短暂性脑缺血发作的应用价值
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摘要
目的探讨CTP(CT灌注成像)与CTA(CT血管成像)诊断颈动脉狭窄性短暂性脑缺血发作的临床价值。方法回顾性分析于2017年2月—2018年1月在该院诊断为短暂性脑缺血发作(TIA)的32例患者的影像学资料,患者均接受常规CT、CTP和CTA诊断,对CTP与CTA的影像学结果进行分析。结果 (1)32例患者中,有28例CT平扫未发现与症状对应的病灶,但CTP检查发现在TTP(达峰时间)上存在与临床症状相对应的灌注异常,且较对侧延迟,但CBF(脑血流量)无区别,其余4例在TTP与CBF图上均无灌注异常;(2)32例患者共进行64支颈动脉CTA检查,结果 ,32例患者中有28例(56支)出现不同程度的血管狭窄,分别包括完全闭塞4支,重度闭塞12支,中度闭塞34支,轻度闭塞6支,无闭塞8支。结论在颈动脉狭窄性短暂性脑缺血的诊断中,应用CTP与CTA可以清晰显示脑组织、颈内动脉的血流动力学变化,临床应用价值较高。
Objective To investigate the clinical value of CTP(CT perfusion imaging) and CTA(CT angiography) in the diagnosis of transient ischemic attack of carotid stenosis. Methods A retrospective analysis of 32 patients with transient ischemic attack(TIA) diagnosed in our hospital from February 2017 to January 2018 was performed. All patients underwent routine CT, CTP, and CTA diagnosis. Analyze the imaging results with CTA and CTP. Results 1.Of the 32 patients, 28 had no lesions corresponding to the symptoms.However, CTP showed that there was a perfusion abnormality corresponding to clinical symptoms at TTP(peak time), and it was delayed compared with the contralateral side, but CBF had no difference in cerebral blood flow. The other 4 cases had no perfusion abnormality on TTP and CBF maps. 2.A total of 64 carotid CTA examinations were performed in 32 patients. As a result, 28(56) of 32 patients showed different degrees. The blood vessels were narrow, including 4 complete occlusions, 12 severe occlusions, 34 moderate occlusions, 6 mild occlusions, and 8 occlusions. Conclusion In the diagnosis of carotid stenosis transient cerebral ischemia, the application of CTP and CTA can clearly show the hemodynamic changes of brain tissue and internal carotid artery, and the clinical application value is higher.
Objective To investigate the clinical value of CTP(CT perfusion imaging) and CTA(CT angiography) in the diagnosis of transient ischemic attack of carotid stenosis. Methods A retrospective analysis of 32 patients with transient ischemic attack(TIA) diagnosed in our hospital from February 2017 to January 2018 was performed. All patients underwent routine CT, CTP, and CTA diagnosis. Analyze the imaging results with CTA and CTP. Results 1.Of the 32 patients, 28 had no lesions corresponding to the symptoms.However, CTP showed that there was a perfusion abnormality corresponding to clinical symptoms at TTP(peak time), and it was delayed compared with the contralateral side, but CBF had no difference in cerebral blood flow. The other 4 cases had no perfusion abnormality on TTP and CBF maps. 2.A total of 64 carotid CTA examinations were performed in 32 patients. As a result, 28(56) of 32 patients showed different degrees. The blood vessels were narrow, including 4 complete occlusions, 12 severe occlusions, 34 moderate occlusions, 6 mild occlusions, and 8 occlusions. Conclusion In the diagnosis of carotid stenosis transient cerebral ischemia, the application of CTP and CTA can clearly show the hemodynamic changes of brain tissue and internal carotid artery, and the clinical application value is higher.
引文
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[11]沙菲菲,王保奇,张利,等.脑CTP联合CTA评价短暂性脑缺血的临床价值[J].中国数字医学,2017,12(7):14-17.
[2]王彬成,鲁慧,崔宁宁,等.缺血预适应对短暂性脑缺血发作患者血管内皮功能及脑梗死发生的影响[J].中国老年学杂志,2018,38(23):5675-5677.
[3]韩冬林,程琦.颈动脉超声检查、ABCD2评分结合血清miR-146a检测对短暂性脑缺血发作患者短期继发脑梗死的预测价值[J].中国老年学杂志,2018,38(21):5152-5155.
[4]王彬成,鲁慧,崔宁宁,等.缺血预适应对短暂性脑缺血发作患者血管弹性与内皮功能损伤的影响[J].山东医药,2018,58(18):61-63.
[5]高学军,魏惠,刘莹莹,等.延安地区缺血性脑卒中和短暂性脑缺血发作患者的血压、血糖、血脂状况调查[J].中风与神经疾病杂志,2018,35(7):622-627.
[6]常琳,常悦悦,余传庆.脑微出血与短暂性脑缺血发作后脑卒中发生的相关性研究[J].中华神经医学杂志,2018,17(8):808-812.
[7]M Wintermark,PC Sanelli,GW Albers,et al.Imaging Recommendations for Acute Stroke and Transient Ischemic Attack Patients:A Joint Statement by the American Society of Neuroradiology,the American College of Radiology and the Society of NeuroInterventional Surgery[J].Journal of the American College of Radiology,2013,10(11):828-832.
[8]A Gupta,JL Chazen,M Hartman,et al.Cerebrovascular Reserve and Stroke Risk in Patients With Carotid Stenosis or Occlusion:A Systematic Review and Meta-Analysis[J].Journal of Vascular Surgery,2013,57(6):1720.
[9]D Ghia,PThomas,D Cordato,et al.Low positive predictive value of the ABCD2score in emergency department transient ischaemic attack diagnoses:the South Western Sydney Transient Ischaemic Attack Study[J].Internal Medici ne Journal,2012,12(8):913-918.
[10]李恒,欧阳福,李湘海,等.活血通络清脑方联合阿司匹林治疗短暂性脑缺血发作性眩晕效果分析[J].山东医药,2018,58(2):62-64.
[11]沙菲菲,王保奇,张利,等.脑CTP联合CTA评价短暂性脑缺血的临床价值[J].中国数字医学,2017,12(7):14-17.