Dynamic perfusion computed tomography in the diagnosis of cerebral vasospasm
Dynamic perfusion computed tomography in the diagnosis of cerebral vasospasm
复制标题
DOI：
10.1227/01.neu.0000222819.18834.33
复制
发表时间：
2006-08-01
期刊：
影响因子：
4.8
通讯作者：
Cohen, Wendy
中科院分区：
文献类型：
--
作者：
Sviri, Gill E.;Britz, Gavin W.;Cohen, Wendy
目的：该研究的目的是将动态灌注计算机断层扫描 (PCT) 扫描测量的绝对脑血流量 (CBF) 和平均短暂时间 (MTT) 与动脉瘤蛛网膜下腔出血后脑血管痉挛患者的临床病程血管痉挛严重程度和灌注异常相关联。 方法：46 名动脉瘤术后血管痉挛患者蛛网膜下腔出血血管痉挛过程中获得了63张PCT图像。所有患者均进行了经颅多普勒测量，28 例进行了血管造影研究，38 例进行了 Tc-99m 单光子发射计算机断层成像与 PCT 扫描结合进行。 结果：迟发性缺血缺损患者的平均最小局部 CBF (rCBF) 和最大局部 MTT 与无迟发性缺血缺损的患者相比显着不同 (22.6 +/- 11.2 cm(3)/100克/分钟，P < 7.3 +/- 2.5 秒对比 3.3 +/- 1.7 秒，P < 0.05）。经颅多普勒测量到严重大脑中动脉血管痉挛的大脑中血管区的平均最小rCBF和最大局部MTT与经颅多普勒测量到无血管痉挛的大脑中血管区相比有显着差异(29.3±1.7cm(3)/100g/min与54.1±25.4cm(3)/100克/分钟，P < 0.01；4.5 +/- 2.4 秒对比 2.8 +/- 1.1 P < 0.001）。单光子发射计算机断层扫描成像估计严重灌注不足的血管区域的平均最小 rCBF 和最大 rMTT 与单光子发射计算机断层扫描成像估计的灌注未受损的血管区域的值显着不同（18.9 +/- 6.9 cm(3)/100 g/min 与 54.2 +/- 23.4 cm(3)/100 g/min，P < 0.001, 0.001；8.1 +/- 1.9 s 与 2.5 +/- 0.39 s，P < 0.001)。结论：本研究表明，一般来说，PCT 定量测量 rCBF 和局部 MTT 与脑血管痉挛患者的临床病程、血管痉挛严重程度和血流动力学损伤具有较高的一致性。动脉瘤性蛛网膜下腔出血。
OBJECTIVE: The aim of the stud was to correlate absolute cerebral blood flow (CBF) and mean transient time (MTT) measured by dynamic perfusion computed tomographic (PCT) scanning with the clinical course vasospasm severity, and perfusion abnormality in patients with cerebral vasospasm after aneurysm subarachnoid hemorrhage.METHODS: Forty-six patients with vasospasm after aneurysmal subarachnoid hemorrhage had 63 PCT images obtained during the course of vasospasm. All patients had transcranial Doppler measurements, 28 had an angiography study, and 38 had Tc-99m single-photon emission computed tomographic imaging performed in conjunction with the PCT scan.RESULTS: The average minimal regional CBF (rCBF) and maximal regional MTT in patients with delayed ischemic deficit were significantly different in comparison with patients without delayed ischemic deficit (22.6 +/- 11.2 cm(3)/100 g/min, P < 0.001; 7.3 +/- 2.5 s versus 3.3 +/- 1.7 s, P < 0.05). The average minimal rCBF and maximal regional MTT in-middle cerebral vascular territories in which severe middle cerebral-artery vasospasm was measured by transcranial Doppler were significantly different in comparison with middle cerebral vascular territories in which no vasospasm was measured by transcranial Doppler (29.3 +/- 1.7 cm(3)/100 g/min versus 54.1 +/- 25.4 cm(3)/100 g/min, P < 0.01; 4.5 +/- 2.4 s versus 2.8 +/- 1.1 P < 0.001). The average minimal rCBF and maximal rMTT in vascular territories with estimated severe hypoperfusion, on single-photon emission computed tomographic imaging were significantly different in comparison with values in vascular territories with unimpaired perfusion as estimated by single-photon emission computed tomographic imaging (18.9 +/- 6.9 cm(3)/100 g/min versus 54.2 +/- 23.4 cm(3)/100 g/min, P < 0.001, 0.001; 8.1 +/- 1.9 s versus 2.5 +/- 0.39 s, P < 0.001).CONCLUSION: The present study suggest that, in general, quantitative measurements of rCBF and regional MTT by PCT show high concordance rates with the clinical course, vasospasm severity, and hemodynamic impairments in patients with cerebral vasospasm aneurysmal subarachnoid hemorrhage.