CAJ | 학술논문

目的：利用全脑CT灌注（CTP）联合CT血管成像（CTA）分析单侧颈内动脉（ICA）闭塞患者的脑血流动力学变化及侧支循环情况。方法对12例单侧ICA闭塞患者行头颅CT平扫、CTP、CTA检查，以5名CTP及20例CTA正常患者的双侧眼动脉、颞浅及枕动脉血管直径作为参考值。分析病变组各灌注参数值的特点及侧支循环代偿情况。结果4例头颅平扫阴性，CBF、CBV、MTT、TTP接近正常，侧支血管代偿良好，双侧眼动脉、颞浅、枕动脉血管直径较正常增粗约62%、64%、50%。8例出现脑梗死，CBF、CBV降低，TTP、MTT延长，侧支血管代偿不良。12例患者Willis环均不完整。结论 CTP联合CTA能很好评估单侧ICA闭塞的脑血流动力学变化及侧支循环情况，在Willis环发育不良的情况下，颅外血管及软、硬脑膜的代偿与其临床转归同样密切相关。
목적：이용전뇌CT관주（CTP）연합CT혈관성상（CTA）분석단측경내동맥（ICA）폐새환자적뇌혈류동역학변화급측지순배정황。방법대12례단측ICA폐새환자행두로CT평소、CTP、CTA검사，이5명CTP급20례CTA정상환자적쌍측안동맥、섭천급침동맥혈관직경작위삼고치。분석병변조각관주삼수치적특점급측지순배대상정황。결과4례두로평소음성，CBF、CBV、MTT、TTP접근정상，측지혈관대상량호，쌍측안동맥、섭천、침동맥혈관직경교정상증조약62%、64%、50%。8례출현뇌경사，CBF、CBV강저，TTP、MTT연장，측지혈관대상불량。12례환자Willis배균불완정。결론 CTP연합CTA능흔호평고단측ICA폐새적뇌혈류동역학변화급측지순배정황，재Willis배발육불량적정황하，로외혈관급연、경뇌막적대상여기림상전귀동양밀절상관。
Objective To evaluate cerebral hemodynamic changes and collateral circulation in patients with unilateral internal carotid artery(ICA)occlusion using whole brain CT perfusion(CTP)and CT angiography(CTA).Methods Unenhanced CT,CTP and CTA were performed on 12 patients with unilateral internal carotid occlusion.The mean diameters of the bilateral ophthalmic, superficial temporal and occipital arteries of 5 persons with normal CTP and 20 persons with normal CTA were used as reference standards.The perfusion parameters including cerebral blood flow(CBF),cerebral blood volume(CBV),mean transit time(MTT), and time to peak(TTP)as well as the collateral circulation of 12 patients were analyzed.Results In 4 patients with unilateral ICA occlusion,unenhanced CT was normal.The CBF,CBV,MTT and TTP were close to normal.The collateral blood supply was good with 62%increase in the diameters of bilateral ophthalmic arteries,64%in the superficial temporal arteries and 50%in the occipital arteries compared with reference standards.In 8 patients with cerebral infarction,the CBF and CBV were decreased,whereas the TTP and MTT were delayed.The collateral blood supply was poor.CTA showed developmentally incomplete circle of Willis in all 12 patients.Conclusions CTP combined with CTA can precisely depict the cerebral hemodynamic changes and collateral circulation supply in incomplete development of the circle of Willis.