CAJ | 학술논문

目的：研究CT灌注(CTP)与MR灌注(PWI)加权成像评价烟雾病血管重建术对烟雾病患者短期脑血流的影响。方法选取我院47例经DSA证实的单侧血管重建术患者为研究对象，均行血管重建术治疗，术前术后接受CTP、PWI检查，获得脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)、达峰时间(TTP)等参数，比较手术前、手术后大脑中动脉(MCA)分布和同侧小脑对照区灌注参数(rCBF、rCBV、rMTT、rTTP)，比较术前、术后CTP与PWI灌注参数相对值差异。结果术后CT灌注图可见右侧MCA分布区CBF、CBV、MTT、TTP与术前比较明显改变，术后PWI灌注图CBF、CBV、MTT、TTP与术前比较明显改变；术后术侧MCA分布区与对照区rCBF、rCBV值与术前比较显著较高(P＜0.05)， rMTT、rTTP与术前比较则显著降低(P＜0.05)。结论 CT灌注与MR灌注加权成像均为行血管重建术烟雾病患者脑血流变化的有效观察方式，可在临床推广应用。
목적：연구CT관주(CTP)여MR관주(PWI)가권성상평개연무병혈관중건술대연무병환자단기뇌혈류적영향。방법선취아원47례경DSA증실적단측혈관중건술환자위연구대상，균행혈관중건술치료，술전술후접수CTP、PWI검사，획득뇌혈용량(CBV)、뇌혈류량(CBF)、평균통과시간(MTT)、체봉시간(TTP)등삼수，비교수술전、수술후대뇌중동맥(MCA)분포화동측소뇌대조구관주삼수(rCBF、rCBV、rMTT、rTTP)，비교술전、술후CTP여PWI관주삼수상대치차이。결과술후CT관주도가견우측MCA분포구CBF、CBV、MTT、TTP여술전비교명현개변，술후PWI관주도CBF、CBV、MTT、TTP여술전비교명현개변；술후술측MCA분포구여대조구rCBF、rCBV치여술전비교현저교고(P＜0.05)， rMTT、rTTP여술전비교칙현저강저(P＜0.05)。결론 CT관주여MR관주가권성상균위행혈관중건술연무병환자뇌혈류변화적유효관찰방식，가재림상추엄응용。
Objective To study CT perfusion (CTP) and MR perfusion (PWI) weighted imaging in evaluating the effect of vascular reconstruction on short-term cerebral blood flow in patients with moyamoya disease.Methods 47 patients with unilateral vascular reconstruction confirmed by DSA in the hospital were selected as the research objects and all received vascular reconstruction. All the patients received CTP and PWI examination before and after operation to obtain parameters, such as cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT) and time to peak (TTP). The preoperative and postoperative distribution of cerebral middle artery (MCA) and ipsilateral cerebellar perfusion parameters in control part (rCBF, rCBV, rMTT and rTTP) were compared as well as the differences in preoperative and postoperative relative value of CTP and PWI perfusion parameters.Results Postoperative CT perfusion image showed that CBF, CBV, MTT and TTP in the right distribution area of MCA significantly changed, compared with those before operation. Postoperative PWI perfusion image showed that CBF, CBV, MTT and TTP significantly significantly changed, compared with those before operation. After operation, rCBF and rCBV values in the distribution area of operation side MCA and the control ares were significantly higher than those before operation (P<0.05) while rMTT and rTTP were significantly lower than those before operation (P<0.05).Conclusion Both of CT perfusion and MR perfusion weighted imaging are the effective observation methods to observe the changes of cerebral blood flow in patients with moyamoya disease, which can be used in clinic.