Clinical Value of Dual-source CT Cerebral Perfusion Imaging in Assessing Cerebral Hemodynamic Changes in Patients with Internal Carotid Atherosclerosis_West China Medical Journal

Authors：

 ZHANGJun

Department of CT/MRI, the Center Hospital of Panzhihua, Panzhihua, Sichuan 617067, P. R. China;

Corresponding author：

Keywords：

Internal carotid artery; Tomography, X-ray computer; Perfusion imaging; Angiography

DOI：

10.7507/1002-0179.20140681

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Objective To explore the clinical value of dual-source CT perfusion imaging (CTPI) in the assessment of cerebral hemodynamic changes in patients with internal carotid atherosclerosis. Methods Thirty patients diagnosed to have internal carotid atherosclerosis by CT angiography examination with various degrees of stenosis or occlusion were treated between January 2012 and May 2013. Whole brain perfusion imaging was performed on all the patients. We rebuilt the CTPI figure parameters respectively, including cerebral blood volume (CBV), blood flow (CBF), mean transit time (MTT) and time to peak (TTP) to assess brain tissue perfusion. Results In the 30 patients with internal carotid atherosclerosis, 8 had mild stenosis lumen, 12 moderate stenosis, 7 severe stenosis and 3 had occlusion. In mild stenosis cases, TTP of stenosis-side vessels was higher than those of coutralateral side (P<0.05), and there were no significant differences in other perfusion parameters between bilateral vessels among mild stenosis cases (P>0.05). MTT and TTP of stenosis-side vessels were higher than those of contralateral side in moderate stenosis cases (P<0.05). In severe stenosis or obstruction cases, MTT and TTP of stenosis-side vessels were higher than those of contralateral side, while CBF and CBV of stenosis-side vessels were lower than contralateral side (P<0.05). Twenty-two in the 30 cases had perfusion abnormalities, and there was a significant difference between the stenosis side cerebral perfusion and the healthy side mirror area (P<0.05). Conclusion CTPI can reflect brain tissue perfusion early and comprehensively, and fully reflect internal carotid atherosclerosis caused by severe stenosis or occlusion of cerebral hemodynamic changes, which provides important information for clinical treatment and helps clinicians to formulate individualized treatment plan.

Citation： ZHANGJun. Clinical Value of Dual-source CT Cerebral Perfusion Imaging in Assessing Cerebral Hemodynamic Changes in Patients with Internal Carotid Atherosclerosis. West China Medical Journal, 2014, 29(12): 2254-2257. doi: 10.7507/1002-0179.20140681 Copy

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9.	罗国君, 王云甫, 何国厚, 等. 颈动脉狭窄或闭塞后侧支循环形成及与临床的相关性[J]. 神经损伤与功能重建, 2009, 4(5):340-342.
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11.	Powers WJ. Hemodynamics and metabolism in ischemic cerebrovascular disease[J]. Neurol Clin, 1992, 10(1):31-48.
12.	Powers W J, Press GA, Grubb RL, et al. The effect of hemodynamically significant carotid artery disease on the hemodynamic status of the cerebral circulation[J]. Ann Intern Med, 1987, 106(1):27-34.
13.	Chaves CJ, Staroselskaya I, Linfante I, et al. Patterns of perfusionweighted imaging in patients with carotid artery occlusive disease[J]. Arch Neurol, 2003, 60(2):237-242.
14.	Derdeyn CP, Powers WJ, Grubb RL Jr. Hemodynamic effects of middle cerebral artery stenosis and occlusion[J]. AJNR Am J Neuroradiol, 1998, 19(8):1463-1469.
15.	许凡勇, 刘志勤, 肖家和, 等. 慢性大动脉狭窄或闭塞性分水岭脑梗死的CT灌注分析[J]. 临床放射学杂志, 2010, 29(7):869-872.

1. Ogasawara K, Ogawa A, Terasaki K, et al. Use of cerebrovascular reactivity in patients with symptomatic major cerebral artery occlusion to predict 5-year outcome:comparison of xenon-133 and iodine-123-IMP single-photon emission computed tomography[J]. J Cereb Blood Flow Metab, 2002, 22(9):1142-1148.
2. Miles KA, London NJ, Lavelle JM, et al. CT staging of renal carcinoma:a prospective comparison of three dynamic computed tomography techniques[J]. Eur J Radiol, 1991, 13(1):37-42.
3. 马秀华, 吕富荣. CT灌注成像在急性脑缺血实验中的应用[J]. 重庆医学, 2009, 38(3):354-356.
4. 高培毅. 脑梗死前期脑局部低灌注的CT灌注成像表现及分期[J]. 中国卒中杂志, 2008, 37(2):115-119.
5. 冷振璞, 满晓, 庞在英, 等. CT灌注成像在超早期缺血性脑血管病的应用研究[J]. 中华神经科杂志, 2003, 36(3):199-202.
6. 甘洁, 王振松. 非梗死性缺血性脑血管病颅脑CT灌注成像诊断价值的研究[J]. 医学影像学杂志, 2009, 19(10):1214-1218.
7. 郭平珍, 李英, 刘怀军. 多层CT脑灌注成像在早期脑梗塞中的应用[J]. 脑与神经疾病杂志, 2003, 11(5):319-320.
8. Hoeffner EG, Case I, Jain R, et al. Cerebral perfusion CT:technique and clinical applications[J]. Radiology, 2004, 231(3):632-644.
9. 罗国君, 王云甫, 何国厚, 等. 颈动脉狭窄或闭塞后侧支循环形成及与临床的相关性[J]. 神经损伤与功能重建, 2009, 4(5):340-342.
10. 梁朝莹, 沈岳飞, 罗小丹, 等. 脑动脉狭窄伴脑梗死患者侧支循环建立情况的探讨[J]. 中风与神经疾病杂志, 2010, 27(12):1097-1101.
11. Powers WJ. Hemodynamics and metabolism in ischemic cerebrovascular disease[J]. Neurol Clin, 1992, 10(1):31-48.
12. Powers W J, Press GA, Grubb RL, et al. The effect of hemodynamically significant carotid artery disease on the hemodynamic status of the cerebral circulation[J]. Ann Intern Med, 1987, 106(1):27-34.
13. Chaves CJ, Staroselskaya I, Linfante I, et al. Patterns of perfusionweighted imaging in patients with carotid artery occlusive disease[J]. Arch Neurol, 2003, 60(2):237-242.
14. Derdeyn CP, Powers WJ, Grubb RL Jr. Hemodynamic effects of middle cerebral artery stenosis and occlusion[J]. AJNR Am J Neuroradiol, 1998, 19(8):1463-1469.
15. 许凡勇, 刘志勤, 肖家和, 等. 慢性大动脉狭窄或闭塞性分水岭脑梗死的CT灌注分析[J]. 临床放射学杂志, 2010, 29(7):869-872.

West China Medical Journal

Clinical Value of Dual-source CT Cerebral Perfusion Imaging in Assessing Cerebral Hemodynamic Changes in Patients with Internal Carotid Atherosclerosis

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