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目的利用CT灌注技术分析慢性大动脉狭窄或闭塞性分水岭脑梗死的血流灌注特征。资料与方法搜集具有完整临床资料的单侧慢性大脑中动脉或颈内动脉重度狭窄或闭塞所致分水岭脑梗死12例,均行CT灌注及数字减影血管造影(DSA)检查。结果分水岭脑梗死的CT灌注特征是脑血容量(CBV)及脑血流量(CBF)降低、平均通过时间(MTT)及峰值时间(TTP)延长;分水岭周围缺血区的CT灌注特征是CBF降低、MTT及TTP延长,CBV无明显变化。结论在慢性大脑中动脉或颈内动脉重度狭窄或闭塞的基础上所致分水岭脑梗死灶周围往往伴有大面积的慢性低灌注脑缺血区,低灌注是分水岭脑梗死的重要促发因素。
Objective To analyze the perfusion characteristics of chronic aortic stenosis or occlusive watershed cerebral infarction by CT perfusion technique. Materials and Methods 12 cases of watershed cerebral infarction due to severe stenosis or occlusion of unilateral chronic middle cerebral artery or internal carotid artery with complete clinical data were collected and examined by CT perfusion and digital subtraction angiography (DSA). Results The CT perfusion characteristics in patients with watershed cerebral infarction were decreased CBF, CBF, MTT and TTP. CT perfusion in the ischemic area around the watershed was decreased by CBF , MTT and TTP prolonged, CBV no significant change. Conclusion Chronic hypoperfusion cerebral ischemic area is often accompanied by severe infarction around the watershed cerebral infarction on the basis of severe stenosis or occlusion of chronic middle cerebral artery or internal carotid artery. Low perfusion is an important predisposing factor in watershed cerebral infarction.