[1]徐慧敏,霍然,刘颖,等.血管选择性动脉自旋标记技术在颈动脉内膜切除术围手术期的应用价值[J].临床神经外科杂志,2019,16(6):527-531.[doi:10.3969/j.issn.1672-7770.2019.06.014]
 XU Hui-min,HUO Ran,LIU Ying,et al.Application of territorial arterial spin labeling in perioperative period of carotid endarterectomy[J].Journal of Clinical Neurosurgery,2019,16(6):527-531.[doi:10.3969/j.issn.1672-7770.2019.06.014]
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血管选择性动脉自旋标记技术在颈动脉内膜切除术围手术期的应用价值()
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《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
16
期数:
2019年第6期
页码:
527-531
栏目:
论著
出版日期:
2019-12-10

文章信息/Info

Title:
Application of territorial arterial spin labeling in perioperative period of carotid endarterectomy
作者:
徐慧敏霍然刘颖赵锡海王涛袁慧书
100191 北京,北京大学第三医院放射科(徐慧敏,霍然,刘颖,袁慧书),神经外科(王涛);清华大学医学院生物医学工程系生物医学影像研究中心(赵锡海)
Author(s):
XU Hui-min HUO Ran LIU Ying et al.
Department of Radiology, Peking University Third Hospital, Beijing 100191, China
关键词:
颈动脉狭窄血管选择性动脉自旋标记颈动脉内膜切除术脑血流灌注
Keywords:
carotid stenosis territorial arterial spin labeling carotid endarterectomy cerebral blood flow
分类号:
R653
DOI:
10.3969/j.issn.1672-7770.2019.06.014
文献标志码:
A
摘要:
【摘要】目的探讨血管选择性动脉自旋标记(territorial arterial spin labeling, t-ASL)技术在颈动脉内膜切除术(carotid endarterectomy,CEA)围手术期的应用价值。方法30例诊断为颈动脉狭窄并拟行CEA手术患者分别于术前2周及术后1周行t-ASL检查,并生成脑血流量(cerebral blood flow, CBF)图及脑供血分布图。分别测量术前及术后双侧颈内动脉供血区的CBF值、双侧颈内动脉供血区及椎-基底动脉供血区的灌注体积(perfusion volume, PV),计算总PV(PV总)。采用配对样本t检验比较同侧术前与术后的CBF值及PV的差异;采用独立样本t检验比较高灌注组与非高灌注组术前PV总的差异。 结果(1)CEA术前的患侧CBF值低于对侧;术后,患侧和对侧的CBF值均上升,且患侧升高幅度大于对侧;(2)CEA术前的患侧PV低于对侧,CEA术后患侧PV明显升高,而对侧PV及椎-基底动脉PV下降;(3)CEA术后发生高灌注患者的术前PV总显著低于非高灌注组,术后两组PV总间未见明显差异。结论t-ASL作为一个无创性脑血流灌注成像方法,既可以于CEA术前对手术疗效及术后发生高灌注综合征的风险进行预测,又可以用于CEA术后疗效评估。
Abstract:
Abstract: ObjectiveTo explore the value of territorial arterial spin labeling(t-ASL) in perioperative period of carotid endarterectomy(CEA). Methods30 patients scheduled CEA due to carotid stenosis underwent t-ASL 2 weeks before and 1 week after surgery to generate cerebral blood flow(CBF) images and brain blood supply area maps respectively. The CBF values of bilateral internal carotid artery(ICA) territory and the perfusion volume(PV) of bilateral ICA and vertebral basilar artery(VBA) territory were measured. And then, the total perfusion volume(PVT) was calculated. The paired-sample t-test was used to compare the CBF value and the PV difference before and after surgery respectively. The independent sample t-test was used to compare the PVT difference between the hyperperfusion group and the non-hyperperfusion group. Results(1)The CBF value of the affected side was lower than that of the contralateral side preoperatively. The CBF values of both the affected side and contralateral side increased after CEA, and the increase of affected side was greater than that of contralateral side. (2)Before CEA, PV on affected side was lower than that on contralateral side. After CEA, PV on affected side was significantly increased, while PV on contralateral side and the VBA territory decreased. (3) PVT in the hyperperfusion group were significantly lower than that in the non-hyperperfusion group before CEA and there was no significant difference between two groups after CEA. ConclusionAs a non-invasive cerebral perfusion imaging method, t-ASL can not only be used to predict the surgical outcome and the risk of hyperperfusion syndrome accident before CEA, but also be used for postoperative evaluation of surgical treatment.

相似文献/References:

[1]周刚,谢轩贵,张洪良.CEA治疗伴对侧颈内动脉闭塞的颈动脉重度狭窄的疗效[J].临床神经外科杂志,2016,(01):28.
[2]张建平,王涛.颈动脉狭窄治疗选择:颈动脉内膜切除术与血管成形和支架植入术[J].临床神经外科杂志,2015,(03):235.
[3]张斌,徐兴国,张慧婷,等.颈动脉内膜剥脱术治疗颈动脉狭窄的临床疗效分析[J].临床神经外科杂志,2019,16(5):406.[doi:10.3969/j.issn.1672-7770.2019.05.008]
 ZHANG Bin,XU Xing-guo,ZHANG Hui-ting,et al.Clinical efficacy of carotid endarterectomy for carotid artery stenosis[J].Journal of Clinical Neurosurgery,2019,16(6):406.[doi:10.3969/j.issn.1672-7770.2019.05.008]

更新日期/Last Update: 2019-12-10