目的:探讨双低剂量320排CT全脑灌注成像联合CTA在慢性脑缺血中的应用,以及单侧大脑中动脉(MCA)狭窄、脑血流灌注情况及其与脑梗死的相关性.方法:收集拟诊为缺血性脑病并经MRA/CTA证实为单侧MCA狭窄患者38例,对照组为脑动脉正常者7例.所有患者均采用320排CT双低剂量方案行全脑灌注检查,同时行头颅MRI检查;测量ROI脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)、达峰时间(TTP)及延迟时间(DLY).采用Kendall's tau_b秩和检验评价脑动脉狭窄程度、脑血流灌注情况及与脑梗死的相关性.结果:①患侧MCA狭窄程度与患侧脑梗死的程度无相关性(P=0.313)、与患侧灌注减低程度无相关性(P=0.848);②患侧灌注异常程度与患侧脑梗死程度呈正相关(P=0.000);③MCA轻度狭窄组与重度狭窄组中出现梗死的单双侧数差异有统计学意义(χ2=9.333,P=0.003).结论:患侧MCA狭窄程度与患侧脑梗死程度、脑灌注血流量降低程度无相关性.%Objective:To investigate the correlation between unilateral middle cerebral artery (MCA) stenosis,cerebral blood perfusion and cerebral infarction by using double-low dose of 320 row CT whole brain perfusion combined with CTA in chronic cerebral ischemia cases. Methods:A total of 38 cases diagnosed as chronic ischemic encephalopathy and confirmed by MRA/CTA with unilateral MCA stenosis were enrolled in the study,7 patients with normal artery for contrast. 45 cases all underwent whole brain perfusion scanning by using double-low-dose of 320 row CT,who underwent MRI examination during the same peri-od. Cerebral blood flow (CBF),brain blood volume (CBV),mean transit time (MTT),time to peak (TTP) and time delay (DLY) in ROI were measured and the perfusion average value were taken for statistical analysis. The correlation relationship were analyzed with Kendall's tau_b test. The difference was statistically significant with P<0.05. Results:①The degree of unilateral MCA stenosis had no relationship with the degree of cerebral infarction and the degree of perfusion decrease (P=0.313,0.848).②There was a positive correlation between the degree of cerebral perfusion disorders and the degree of cerebral infarction (P=0.000). ③There was significant difference between the mild stenosis group and the severe stenosis group in the side num-bers of infarction (χ2=9.333,P=0.003). Conclusion:There was no correlation between the degree of unilateral MCA stenosis and the degree of cerebral infarction,or the degree of perfusion decrease.
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