Qu Hui, Li Jinli, Zhao Xingquan, Dong Kehui
Department of Neurology, Beijing Tiantan Hospital affiliated to Capital Medical University, Beijing 100050, P.R. China.
Exp Ther Med. 2013 Feb;5(2):471-474. doi: 10.3892/etm.2012.805. Epub 2012 Nov 9.
The aim of this study was to investigate the factors affecting pre- and post-stenting head computed tomography perfusion (CTP) in patients with middle cerebral artery stenosis. A total of 25 patients with severe middle cerebral artery stenosis were enrolled. CTP was performed prior to and following stenting. Scores were allocated to the time-to-peak (TTP) parameter of CTP using the Alberta stroke program early computed tomography scoring (ASPECTS) scale. The factors possibly affecting pre- and post-stenting CTP were analyzed. All the patients exhibited markedly prolonged TTP on the affected side prior to stenting, compared with the healthy side. Following surgery, the TTP was improved in all patients. The preoperative ASPECTS score was negatively correlated with the degree of middle cerebral artery stenosis with a correlation coefficient of -5.78. The preoperative vascular stenosis rate was positively correlated with the improvement degree of the ASPECTS score with a correlation coefficient of 1.137 (P=0.001). TTP is a sensitive parameter for evaluating the effect of stenting on middle cerebral artery stenosis. TTP prior to and following stenting may be quantitatively assessed using the ASPECTS scale. Patients with serious stenosis and/or good collateral circulation are able to benefit more from stenting.
本研究旨在探讨影响大脑中动脉狭窄患者支架置入术前和术后头颅计算机断层扫描灌注(CTP)的因素。共纳入25例大脑中动脉严重狭窄患者。在支架置入术前和术后进行CTP检查。使用阿尔伯塔卒中项目早期计算机断层扫描评分(ASPECTS)量表对CTP的达峰时间(TTP)参数进行评分。分析可能影响支架置入术前和术后CTP的因素。所有患者在支架置入术前,患侧TTP与健侧相比均显著延长。术后,所有患者的TTP均有所改善。术前ASPECTS评分与大脑中动脉狭窄程度呈负相关,相关系数为-5.78。术前血管狭窄率与ASPECTS评分改善程度呈正相关,相关系数为1.137(P=0.001)。TTP是评估支架置入术对大脑中动脉狭窄疗效的敏感参数。支架置入术前和术后的TTP可使用ASPECTS量表进行定量评估。狭窄严重和/或侧支循环良好的患者能从支架置入术中获益更多。