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首页> 外文期刊>Journal of Cerebral Blood Flow and Metabolism: Official Journal of the International Society of Cerebral Blood Flow and Metabolism >Pre-and postoperative cerebral blood flow changes in patients with idiopathic normal pressure hydrocephalus measured by computed tomography (CT)-perfusion
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Pre-and postoperative cerebral blood flow changes in patients with idiopathic normal pressure hydrocephalus measured by computed tomography (CT)-perfusion

机译：计算机断层扫描（CT）灌注测量特发性正常压力脑积水患者的术前和术后脑血流变化

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摘要

In idiopathic normal pressure hydrocephalus (iNPH), the cerebral blood flow (CBF) is of pathophysiological interest and a potential biomarker. Computed tomography perfusion (CTP), an established technique with high spatial resolution and quantitative measurements, has not yet been used in the iNPH context. If CTP were sensitive to the CBF levels and changes in iNPH, this technique might provide diagnostic and prognostic absolute perfusion thresholds. The aim of this work was to determine the applicability of CTP to iNPH. CBF measurements of 18 patients pre- and 17 three months postoperatively, and six healthy individuals (HI) were evaluated in 12 cortical and subcortical regions of interest. Correlations between CBF and symptomatology were analyzed in shunt-responders. Compared to HI, the preoperative CBF in iNPH was significantly reduced in normal appearing and periventricular white matter (PVWM), the lentiform nucleus and the global parenchyma. No CBF differences were shown between responders and non-responders. In responders, the CBF recovered postoperatively by 2.5-32% to approximately the level of HI, but remained significantly decreased in the PVWM of non-responders. The pre- and postoperative CBF of cortical and subcortical regions correlated with the intensity of symptoms. In spite of limited spatial coverage, CTP can measure CBF changes in iNPH.
机译：在特发性常压脑积水（iNPH）中，脑血流（CBF）具有病理生理意义，并且是潜在的生物标志物。在iNPH背景下，计算机断层扫描灌注（CTP）是一项具有高空间分辨率和定量测量的成熟技术。如果CTP对CBF水平和iNPH的变化敏感，则该技术可能提供诊断和预后的绝对灌注阈值。这项工作的目的是确定CTP对iNPH的适用性。分别在术前和术后三个月对18例患者和17例患者进行了CBF测量，并在12个感兴趣的皮质和皮质下区域评估了6名健康个体（HI）。在分流响应者中分析了CBF与症状之间的相关性。与HI相比，iNPH的术前CBF在正常出现和脑室周围白质（PVWM），大肠状核和整体实质中均明显降低。在应答者和非应答者之间没有显示出CBF差异。在有反应者中，CBF术后恢复了2.5-32％，达到了HI的水平，但在无反应者的PVWM中仍显着下降。皮质和皮质下区域的术前和术后CBF与症状的强度相关。尽管空间覆盖范围有限，但是CTP可以测量iNPH中的CBF变化。

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