国际脑血管病杂志
國際腦血管病雜誌
국제뇌혈관병잡지
INTERNATIONAL JOURNAL OF CEREBROVASCULAR DISEASES
2013年
12期
881-885
,共5页
脑缺血发作,短暂性%灌注成像%体层摄影术,X线计算机%弥散磁共振成像%脑血管造影术%颅内动脉硬化
腦缺血髮作,短暫性%灌註成像%體層攝影術,X線計算機%瀰散磁共振成像%腦血管造影術%顱內動脈硬化
뇌결혈발작,단잠성%관주성상%체층섭영술,X선계산궤%미산자공진성상%뇌혈관조영술%로내동맥경화
Ischemic Attack,Transient%Perfusion Imaging%Tomography,X-Ray Computed%Diffusion Magnetic Resonance Imaging%Cerebral Angiography%Intracranial Arteriosclerosis
目的 探讨短暂性脑缺血发作(transient ischemic attack,TIA)患者CT灌注成像(CT perfusion,CTP)变化以及出现CTP异常的危险因素.方法 纳入TIA行CTP和CT血管造影检查的患者.获得脑血流量(cerebral blood flow,CBF)、脑血容量(cerebral blood volume,CBV)、平均通过时间(mean transit time,MTT)和达峰时间(time to peak,TTP)等参数值,通过与对侧镜像区进行比较确定CTP异常.对CTP异常组与正常组人口统计学和基线临床资料进行比较,采用多变量logistic回归分析确定TIA患者出现CTP异常的危险因素.结果 共纳入69例TIA患者,其中52例存在与临床症状相对应的灌注异常,表现为TTP和MTT延长,但CBF和CBV下降不明显.多变量logistic回归分析显示,国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分较高[优势比(odds ratio,OR)1.991,95％可信区间(confidence interval,CI)1.113 ～3.564；P=0.020]、症状持续时间较长(OR l.062,95％ CI l.013～1.114；P=0.013)以及伴有颅内血管狭窄(OR 15.410,95％ CI2.118 ～112.116；P=0.007)是TIA患者出现CTP异常的独立危险因素.相关性分析显示,TTP延长(r=0.389,P=0.001)和MTT延长(r=0.413,P=0.001)与NIHSS评分显著相关.结论 TTP和MTT能敏感地显示TIA患者的脑灌注异常,病情越严重,CTP异常率越高.
目的 探討短暫性腦缺血髮作(transient ischemic attack,TIA)患者CT灌註成像(CT perfusion,CTP)變化以及齣現CTP異常的危險因素.方法 納入TIA行CTP和CT血管造影檢查的患者.穫得腦血流量(cerebral blood flow,CBF)、腦血容量(cerebral blood volume,CBV)、平均通過時間(mean transit time,MTT)和達峰時間(time to peak,TTP)等參數值,通過與對側鏡像區進行比較確定CTP異常.對CTP異常組與正常組人口統計學和基線臨床資料進行比較,採用多變量logistic迴歸分析確定TIA患者齣現CTP異常的危險因素.結果 共納入69例TIA患者,其中52例存在與臨床癥狀相對應的灌註異常,錶現為TTP和MTT延長,但CBF和CBV下降不明顯.多變量logistic迴歸分析顯示,國立衛生研究院卒中量錶(National Institutes of Health Stroke Scale,NIHSS)評分較高[優勢比(odds ratio,OR)1.991,95％可信區間(confidence interval,CI)1.113 ～3.564；P=0.020]、癥狀持續時間較長(OR l.062,95％ CI l.013～1.114；P=0.013)以及伴有顱內血管狹窄(OR 15.410,95％ CI2.118 ～112.116；P=0.007)是TIA患者齣現CTP異常的獨立危險因素.相關性分析顯示,TTP延長(r=0.389,P=0.001)和MTT延長(r=0.413,P=0.001)與NIHSS評分顯著相關.結論 TTP和MTT能敏感地顯示TIA患者的腦灌註異常,病情越嚴重,CTP異常率越高.
목적 탐토단잠성뇌결혈발작(transient ischemic attack,TIA)환자CT관주성상(CT perfusion,CTP)변화이급출현CTP이상적위험인소.방법 납입TIA행CTP화CT혈관조영검사적환자.획득뇌혈류량(cerebral blood flow,CBF)、뇌혈용량(cerebral blood volume,CBV)、평균통과시간(mean transit time,MTT)화체봉시간(time to peak,TTP)등삼수치,통과여대측경상구진행비교학정CTP이상.대CTP이상조여정상조인구통계학화기선림상자료진행비교,채용다변량logistic회귀분석학정TIA환자출현CTP이상적위험인소.결과 공납입69례TIA환자,기중52례존재여림상증상상대응적관주이상,표현위TTP화MTT연장,단CBF화CBV하강불명현.다변량logistic회귀분석현시,국립위생연구원졸중량표(National Institutes of Health Stroke Scale,NIHSS)평분교고[우세비(odds ratio,OR)1.991,95％가신구간(confidence interval,CI)1.113 ～3.564；P=0.020]、증상지속시간교장(OR l.062,95％ CI l.013～1.114；P=0.013)이급반유로내혈관협착(OR 15.410,95％ CI2.118 ～112.116；P=0.007)시TIA환자출현CTP이상적독립위험인소.상관성분석현시,TTP연장(r=0.389,P=0.001)화MTT연장(r=0.413,P=0.001)여NIHSS평분현저상관.결론 TTP화MTT능민감지현시TIA환자적뇌관주이상,병정월엄중,CTP이상솔월고.
Objective To investigate the changes of CT perfusion (CTP) imaging and the risk factors for CTP abnormality in patients with transient ischemic attack (TIA).Methods TIA patients were enrolled; CTP and CT angiography were performed.The parameter values of cerebral blood flow (CBF),cerebral blood volume (CBV),mean transit time (MTT),and time to peak (TTP) were obtained.CTP abnormalities were identified by comparing the contralateral mirror area.Demography and baseline clinical data were compared in a CTP imaging abnormal group and a normal group.Multivariate logistic regression analysis was used to identify the risk factors for CTP abnormality in patients with TIA.Results A total of 69 patients with TIA were enrolled,and 52 of them had perfusion abnormalities corresponding to clinical symptoms.Their TTP and MTT were prolonged,but the decreased CBF and CBV was not obvious.Multivariate logistic regression analysis showed that the higher National Institutes of Health Stroke Scale (NIHSS) score (odds ratio [OR] 1.991,95％ confidence interval [OR] 1.113-3.564; P=0.020),the longer duration of symptoms (OR 1.062,95％ OR 1.013-1.114; P =0.013),and intracranial vascular stenosis (OR 15.410,95％ OR 2.118-112.116; P=0.007) were the independent risk factors for CTP abnormality in patients with TIA.The correlation analysis showed that the prolonged TTP (r =0.389,P =0.001) and MTT (r =0.413,P=0.001) were significantly associated with the NIHSS score.Conclusions TTP and MTT may sensitivity reveal cerebral perfusion abnormalities in patients with TIA.The more severe the disease is,the higher the CTP abnormal rate will be.
