Griffiths P D, Gaines P, Cleveland T, Beard J, Venables G, Wilkinson I D
Unit of Academic Radiology, Floor C, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, UK.
Neuroradiology. 2005 Mar;47(3):175-82. doi: 10.1007/s00234-005-1362-z. Epub 2005 Mar 15.
We describe an MR-based methodology designed to study cerebral haemodynamic compromise in patients with symptomatic carotid occlusions. We present the results of eight patients who underwent MR angiography of the cervical carotids and circle of Willis, MR imaging of the brain and dynamic gadolinium MR perfusion studies before and after the injection of the carbonic anhydrase inhibitor acetazolamide. All patients showed increased transit times in the symptomatic hemisphere at rest indicating reduced flow. The transit time asymmetries became more pronounced after acetazolamide in all patients because of failed vasodilatation on the affected side. There was an inverse correlation between the degree of increased transit time and the degree of collateralisation around the circle of Willis. We believe that demonstration of both macroscopic vascular anatomy and microvascular reserve is important when assessing patients with possible low-flow states and the described method is a robust means of obtaining that data.
我们描述了一种基于磁共振成像（MR）的方法，旨在研究有症状颈动脉闭塞患者的脑血流动力学损害情况。我们展示了8例患者的研究结果，这些患者在注射碳酸酐酶抑制剂乙酰唑胺前后，均接受了颈部颈动脉及 Willis 环的 MR 血管造影、脑部 MR 成像以及动态钆增强 MR 灌注研究。所有患者在静息状态下，症状侧半球的通过时间均延长，提示血流减少。由于患侧血管扩张失败，所有患者在注射乙酰唑胺后通过时间不对称性更加明显。通过时间增加的程度与 Willis 环周围侧支循环的程度呈负相关。我们认为，在评估可能存在低血流状态的患者时，展示宏观血管解剖结构和微血管储备都很重要，而所描述的方法是获取这些数据的可靠手段。
