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前循环急性卒中不同脑叶的认知障碍与 CT 灌注的相关性。

Associations between cognitive impairment and computed tomography perfusion in different lobes in acute stroke of the anterior circulation.

机构信息

Anhui Medical University, Second Affiliated Hospital, Department of Neurology, Hefei, China.

Anhui Medical University, Third Affiliated Hospital, Department of Neurology, Hefei, China.

出版信息

Arq Neuropsiquiatr. 2023 Jun;81(6):524-532. doi: 10.1055/s-0043-1768663. Epub 2023 Jun 28.

Abstract

BACKGROUND

Cognitive impairment (CI) during the acute phase of stroke should not be ignored. The present study analyzed the relationship between computed tomography perfusion (CTP) in different lobes and CI during the acute phase of stroke in patients with cerebral infarction.

METHODS

The present study included 125 subjects: 96 in the acute phase of stroke and 29 elderly healthy subjects as a control group. The Montreal Cognitive Assessment (MoCA) was used to evaluate the cognitive status of the two groups. The CTP scans include four parameters: cerebral blood flow (CBF), cerebral blood volume (CBV), time to peak (TTP), and mean transit time (MTT).

RESULTS

The MoCA scores for naming, language and delayed recall significantly decreased only in patients with left cerebral infarctions. The MTT of the left vessels in the occipital lobe and the CBF of the right vessels in the frontal lobe were negatively related to the MoCA scores of patients with left infarction. The CBV of the left vessels in the frontal lobe and the CBF of left vessels in the parietal lobe were positively linked to the MoCA scores of patients with left infarction. The CBF of the right vessels in the temporal lobe was positively related to the MoCA scores of patients with right infarction. Finally, the CBF of the left vessels in the temporal lobe was inversely correlated with the MoCA scores of patients with right infarctions.

CONCLUSION

During the acute phase of stroke, CTP was closely associated with CI. Changed CTP could be a potential neuroimaging biomarker to predict CI during the acute phase of stroke.

摘要

背景

脑卒中急性期认知障碍(CI)不容忽视。本研究分析了脑梗死患者不同脑叶 CT 灌注(CTP)与急性期 CI 的关系。

方法

本研究共纳入 125 例患者:急性脑卒中 96 例,老年健康对照组 29 例。采用蒙特利尔认知评估量表(MoCA)评估两组认知状况。CTP 扫描包括四个参数:脑血流(CBF)、脑血容量(CBV)、达峰时间(TTP)和平均通过时间(MTT)。

结果

左侧大脑梗死患者的 MoCA 评分在命名、语言和延迟回忆方面显著下降。左侧枕叶血管 MTT 和右侧额叶血管 CBF 与左侧梗死患者 MoCA 评分呈负相关。左侧额叶血管 CBV 和左侧顶叶血管 CBF 与左侧梗死患者 MoCA 评分呈正相关。右侧颞叶血管 CBF 与右侧梗死患者 MoCA 评分呈正相关。最后,左侧颞叶血管 CBF 与右侧梗死患者 MoCA 评分呈负相关。

结论

脑卒中急性期 CTP 与 CI 密切相关。改变的 CTP 可能是预测脑卒中急性期 CI 的潜在神经影像学生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f9a4/10307000/076cbd560cb9/10-1055-s-0043-1768663-i220145-1.jpg

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