Clinical Value of Dual-source CT Cerebral Perfusion Imaging in Assessing Cerebral Hemodynamic Changes in Patients with Internal Carotid Atherosclerosis_West China Medical Journal

Authors：

 ZHANGJun

Department of CT/MRI, the Center Hospital of Panzhihua, Panzhihua, Sichuan 617067, P. R. China;

Corresponding?author：

Keywords：

Internal carotid artery; Tomography, X-ray computer; Perfusion imaging; Angiography

DOI：

10.7507/1002-0179.20140681

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Objective To explore the clinical value of dual-source CT perfusion imaging (CTPI) in the assessment of cerebral hemodynamic changes in patients with internal carotid atherosclerosis. Methods Thirty patients diagnosed to have internal carotid atherosclerosis by CT angiography examination with various degrees of stenosis or occlusion were treated between January 2012 and May 2013. Whole brain perfusion imaging was performed on all the patients. We rebuilt the CTPI figure parameters respectively, including cerebral blood volume (CBV), blood flow (CBF), mean transit time (MTT) and time to peak (TTP) to assess brain tissue perfusion. Results In the 30 patients with internal carotid atherosclerosis, 8 had mild stenosis lumen, 12 moderate stenosis, 7 severe stenosis and 3 had occlusion. In mild stenosis cases, TTP of stenosis-side vessels was higher than those of coutralateral side (P<0.05), and there were no significant differences in other perfusion parameters between bilateral vessels among mild stenosis cases (P>0.05). MTT and TTP of stenosis-side vessels were higher than those of contralateral side in moderate stenosis cases (P<0.05). In severe stenosis or obstruction cases, MTT and TTP of stenosis-side vessels were higher than those of contralateral side, while CBF and CBV of stenosis-side vessels were lower than contralateral side (P<0.05). Twenty-two in the 30 cases had perfusion abnormalities, and there was a significant difference between the stenosis side cerebral perfusion and the healthy side mirror area (P<0.05). Conclusion CTPI can reflect brain tissue perfusion early and comprehensively, and fully reflect internal carotid atherosclerosis caused by severe stenosis or occlusion of cerebral hemodynamic changes, which provides important information for clinical treatment and helps clinicians to formulate individualized treatment plan.

Citation： ZHANGJun. Clinical Value of Dual-source CT Cerebral Perfusion Imaging in Assessing Cerebral Hemodynamic Changes in Patients with Internal Carotid Atherosclerosis. West China Medical Journal, 2014, 29(12): 2254-2257. doi: 10.7507/1002-0179.20140681 Copy

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9.	羅國君, 王云甫, 何國厚, 等. 頸動脈狹窄或閉塞后側支循環形成及與臨床的相關性[J]. 神經損傷與功能重建, 2009, 4(5):340-342.
10.	梁朝瑩, 沈岳飛, 羅小丹, 等. 腦動脈狹窄伴腦梗死患者側支循環建立情況的探討[J]. 中風與神經疾病雜志, 2010, 27(12):1097-1101.
11.	Powers WJ. Hemodynamics and metabolism in ischemic cerebrovascular disease[J]. Neurol Clin, 1992, 10(1):31-48.
12.	Powers W J, Press GA, Grubb RL, et al. The effect of hemodynamically significant carotid artery disease on the hemodynamic status of the cerebral circulation[J]. Ann Intern Med, 1987, 106(1):27-34.
13.	Chaves CJ, Staroselskaya I, Linfante I, et al. Patterns of perfusionweighted imaging in patients with carotid artery occlusive disease[J]. Arch Neurol, 2003, 60(2):237-242.
14.	Derdeyn CP, Powers WJ, Grubb RL Jr. Hemodynamic effects of middle cerebral artery stenosis and occlusion[J]. AJNR Am J Neuroradiol, 1998, 19(8):1463-1469.
15.	許凡勇, 劉志勤, 肖家和, 等. 慢性大動脈狹窄或閉塞性分水嶺腦梗死的CT灌注分析[J]. 臨床放射學雜志, 2010, 29(7):869-872.

1. Ogasawara K, Ogawa A, Terasaki K, et al. Use of cerebrovascular reactivity in patients with symptomatic major cerebral artery occlusion to predict 5-year outcome:comparison of xenon-133 and iodine-123-IMP single-photon emission computed tomography[J]. J Cereb Blood Flow Metab, 2002, 22(9):1142-1148.
2. Miles KA, London NJ, Lavelle JM, et al. CT staging of renal carcinoma:a prospective comparison of three dynamic computed tomography techniques[J]. Eur J Radiol, 1991, 13(1):37-42.
3. 馬秀華, 呂富榮. CT灌注成像在急性腦缺血實驗中的應用[J]. 重慶醫學, 2009, 38(3):354-356.
4. 高培毅. 腦梗死前期腦局部低灌注的CT灌注成像表現及分期[J]. 中國卒中雜志, 2008, 37(2):115-119.
5. 冷振璞, 滿曉, 龐在英, 等. CT灌注成像在超早期缺血性腦血管病的應用研究[J]. 中華神經科雜志, 2003, 36(3):199-202.
6. 甘潔, 王振松. 非梗死性缺血性腦血管病顱腦CT灌注成像診斷價值的研究[J]. 醫學影像學雜志, 2009, 19(10):1214-1218.
7. 郭平珍, 李英, 劉懷軍. 多層CT腦灌注成像在早期腦梗塞中的應用[J]. 腦與神經疾病雜志, 2003, 11(5):319-320.
8. Hoeffner EG, Case I, Jain R, et al. Cerebral perfusion CT:technique and clinical applications[J]. Radiology, 2004, 231(3):632-644.
9. 羅國君, 王云甫, 何國厚, 等. 頸動脈狹窄或閉塞后側支循環形成及與臨床的相關性[J]. 神經損傷與功能重建, 2009, 4(5):340-342.
10. 梁朝瑩, 沈岳飛, 羅小丹, 等. 腦動脈狹窄伴腦梗死患者側支循環建立情況的探討[J]. 中風與神經疾病雜志, 2010, 27(12):1097-1101.
11. Powers WJ. Hemodynamics and metabolism in ischemic cerebrovascular disease[J]. Neurol Clin, 1992, 10(1):31-48.
12. Powers W J, Press GA, Grubb RL, et al. The effect of hemodynamically significant carotid artery disease on the hemodynamic status of the cerebral circulation[J]. Ann Intern Med, 1987, 106(1):27-34.
13. Chaves CJ, Staroselskaya I, Linfante I, et al. Patterns of perfusionweighted imaging in patients with carotid artery occlusive disease[J]. Arch Neurol, 2003, 60(2):237-242.
14. Derdeyn CP, Powers WJ, Grubb RL Jr. Hemodynamic effects of middle cerebral artery stenosis and occlusion[J]. AJNR Am J Neuroradiol, 1998, 19(8):1463-1469.
15. 許凡勇, 劉志勤, 肖家和, 等. 慢性大動脈狹窄或閉塞性分水嶺腦梗死的CT灌注分析[J]. 臨床放射學雜志, 2010, 29(7):869-872.

West China Medical Journal

Clinical Value of Dual-source CT Cerebral Perfusion Imaging in Assessing Cerebral Hemodynamic Changes in Patients with Internal Carotid Atherosclerosis

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