摘要
目的探讨一站式CTA联合CTP扫描在颈内动脉起始部重度狭窄介入治疗中的价值。方法选取2016-07—2018-07收治的颈内动脉重度狭窄行CAS治疗的患者24例,研究组术前行一站式CTA)联合CTP扫描,术后复查CTP及CTA定期随访。选取2012-07—2016-06收治的颈内动脉重度狭窄行CAS治疗的患者36例为对照组,未行CTP及CTA扫描直接行DSA检查。对比2组并发症发生率、漏检率及1a后mRS评分。结果研究组未出现高灌注脑病、出血转化及脑疝形成等并发症。对照组中2例出现症状性颅内出血,1例出现高灌注脑病,并发症发生率8.3%,2组对比差异无统计学意义(P=0.268)。随访中研究组应检次数72次,共出现漏检3次,漏检率4.2%(3/72)。对照组应检次数72次,出现漏检14次,漏检率19.4%(14/72)。对照组明显高于研究组,差异有统计学意义(χ2=8.070,P=0.004)。研究组1a后mRS评分(0.89±0.54)分,对照组为(1.64±1.30)分,研究组明显优于对照组,差异有统计学意义(P<0.05)。结论一站式CTA联合CTP扫描可能有助于减少颈内动脉起始部重度狭窄介入治疗后并发症的发生,降低手术风险,显著降低患者1a余mRS评分,改善远期临床预后,提高患者生活质量。CTA、CTP属无创性检查,费用低,简便易行,有助于提高患者依从性,减少漏检、失访等。
Objective To analyze the application value of one stop CTA combined with CTP scan in interventional treatment of severe internal carotid artery stenosis. Methods 24 patients with severe internal carotid artery stenosis treated with CAS from July 2016 to July 2018 were selected as the research group,which was evaluated with CTA （one stop CTA） and CTP scan before operation,and carried out the follow up CTP and CTA regularly after operation.36 patients with severe internal carotid artery stenosis treated with CAS from July 2012 to June 2016 were selected as the control group,which was directly examined with DSA without the CTP and CTA scan.After that,the incidence of complications,loss detecting rate and mRS score 1 year later were compared between the patients in these two groups. Results The research group had no complications such as hyperperfusion encephalopathy,hemorrhagic transformation and cerebral hernia formation.In the control group,2 patients with symptomatic intracranial hemorrhage and 1 patient with hyperperfusion encephalopathy were found,and the incidence of complications was 8.3%.There was no statistical significance between the two groups （ P =0.268）.During the follow up,the required detection times for the research group was 72,the missed times was 3,and the loss detecting rate was 4.2% （3/72）.As for the control,the required detection times for the research group was 72,the missed times was 14,and the loss detecting rate was 19.4% （14/72）.Compared with the control group,the control group was significantly higher than that in the research group,with statistical significance （χ ^2=8.070, P =0.004）.After one year,the mRS score of the patients was 0.89±0.54 in research group and 1.64 ±1.30 in the control group,which was significantly better than that in the control group with the statistical significance （ P 〈0.05）. Conclusion One stop CTA combined with CTP scan may be conducive to reduce the incidence of complications after interventional treatment of severe internal carotid artery stenosis,to reduce the risk of surgery,which can significantly reduce the mRS score in patients one year later,improve the long term clinical prognosis,and improve the life quality of patients.Further,CTA and CTP is a kind of noninvasive examination with low cost and easy to perform,which contributes to improving the patient’s compliance,so as to reduce the missed examination and the missing follow up.
作者
潘毓敦
吴美娜
傅懋林
PAN Yudun;WU Meina;FU Maolin(Department of Imaging,Quanzhou First Hospital,Quanzhou 362000,China;Department of Neurology,180th Hospital of PLA,Quanzhou 362000,China)
出处
《中国实用神经疾病杂志》
2018年第17期1878-1883,共6页
Chinese Journal of Practical Nervous Diseases
关键词
一站式
CT灌注成像
CT血管重建图像
颈内动脉狭窄
介入治疗
One stop；CT perfusion weighted imaging；CT vascular reconstruction image；Internal carotid artery stenosis；Interventional therapy
作者简介
潘毓敦，Email：pyudun@163.com
