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目的利用氙气CT(XeCT)技术分析颈动脉重度狭窄的血流动力学特点,并以此评价支架成形术的疗效。方法对13例颈动脉重度狭窄进行支架成形治疗,并利用XeCT进行血流定量评价。患者术前及术后1周分别接受XeCT检查,根据病变侧大脑皮层的脑血流值分为正常区、轻度缺血区、可逆性缺血区和梗死区,并按缺血面积大小作术前、术后对比。结果所有患者术前局部脑血流量均有不同程度降低,以大脑中动脉分布区最为显著;术后脑血流值有显著改善,轻度缺血区面积由32.63%变为14.22%,可逆性缺血区面积由13.54%变为8.38%,正常区域面积由47.51%变为71.13%,而梗死面积无显著变化。结论颈动脉重度狭窄时,脑组织存在易导致脑梗死的缺血区域,支架成形术治疗可明显改善患者的血流动力学障碍,其疗效可以通过定量的脑血流测定得到客观和准确的评价。
Objective To evaluate the hemodynamic characteristics of severe carotid stenosis by xenographic CT (XeCT) technique and to evaluate the efficacy of stenting. Methods Thirteen patients with severe carotid stenosis were treated with scaffolds. XeCT was used to evaluate the blood flow. The patients underwent XeCT examination before surgery and one week after surgery respectively. According to the cerebral blood flow of the lesion side cerebral cortex, they were divided into normal zone, mild ischemic zone, reversible ischemic zone and infarct zone. According to the size of ischemic area Preoperative and postoperative contrast. Results All patients had preoperative local cerebral blood flow decreased to varying degrees, the most prominent distribution of the middle cerebral artery; postoperative cerebral blood flow value was significantly improved mild ischemic area from 32.63% to 14.22%, reversible The ischemic area changed from 13.54% to 8.38%, and the normal area changed from 47.51% to 71.13%, while the infarct size did not change significantly. Conclusions In severe carotid stenosis, there is an ischemic region in the brain tissue that may lead to cerebral infarction. Stent angioplasty treatment can significantly improve the patients’ hemodynamic disorders. The curative effect can be objectively and accurately evaluated by quantitative cerebral blood flow measurement .