| Objective: To observe the changes of regional cerebral blood flow and blood-supply artery, to study the value of CTPI and CTA in the clinical diagnosis of Transient ischemic attack (TIA) of Internal carotid artery system, by using the computerized tomography perfusion imaging (CTPI) combined with computerized tomography angiography (CTA). And then further exploring the etiological factors and pathophysiological mechanism of TIA of Internal carotid artery system.Methods: 35 patients with TIA of Internal carotid artery system, which clinical symptoms displayed mainly dizziness was enrolled into the patient group randomly, 22 healthy peoples without TIA of Internal carotid artery system symptoms and CTA negative were enrolled as control group. 35 cases within 48h were examined with 16 slice CT perfusion imaging (CTPI) and CTA in head and neck. The interesting regional mean transmit time (MTT), cerebral blood flow (CBF) and cerebral blood volume (CBV) were analyzed, and discussing the relationship with CTA and clinical manifestations.Results:1.28(80%)of 35 patients with TIA of Internal carotid artery system were revealed abnormal perfusion regions corresponding to clinical symptom in CTPI, of which there were 28 cases revealed abnormal perfusion regions on mean transmit time (MTT) maps, and 23 cases on cerebral blood flow (CBF) maps, only 15 on cerebral blood volume (CBV) maps. Other 7 cases showed normal results in CTPI. 2.In 35 cases with TIA of Internal carotid artery system, the MTT of affected side (4.97±2.65)s compared with that of the contralateral side (3.94±0.69)s was significantly prolonged (P<0.05); Also, the CBF of affected side (58.68±52.73)ml·100g-1·min-1 compared with that of the contralateral side (68.27±60.32)ml·100g-1·min-1 was significantly different (P<0.05); And the difference of the CBV (P>0.05) was not statistically significant between the affected side (2.98±2.12)ml·100g-1 and the contralateral side(3.01±2.15)ml·100g-1.3.The average△MTT of the patient group(1.23±2.23)s compared with that of the controlled group(0.23±0.19)s was significantly different (P<0.05); The average△CBF of the patients group(11.11±11.40) ml·100g-1·min-1compared with that of the controlled group(4.68±5.14) ml·100g-1·min-1 was significantly different (P<0.05); The difference of theΔCBV (P>0.05) was not statistically significant between the patients group(0.25±0.22) ml·100g-1and the controlled group (0.21±0.20) ml·100g-1.4.In 35 cases checked by CTA, there were 28 cases (80%) with abnormal vascular. Among them 25 cases (89%) were revealed perfusion abnormalities, which were matched with clinical symptoms. There were 3 cases (43%) with perfusion abnormalities but without abnormal vascular. Through statistical analysis, there was a significant difference of perfusion abnormalities between the cases with abnormal vascular and without abnormal vascular.5.The correspondence relationship between CTPI and CTA abnormality had the following 4 types: (1) There were 25 cases (71%) with perfusion abnormalities accompanied by abnormal vascular supplying the abnormal perfusion region (convict vascular). Among them, 16 cases had carotid artery stenosis, 13 cases had many weak vascular plaques, and 6 cases had carotid artery dysplasia, the coexistence of a number of factors and situation. (2) There were 3 cases (9%) with perfusion abnormalities in CTPI but without abnormal vascular in CTA. (3) There were 3 cases (9%) with abnormal vascular in CTA but without perfusion abnormalities in CTPI. (4) There were 4 cases (11%) neither had abnormal vascular nor had perfusion abnormalities. Conclusions:1.MTT is the most sensitive and primary indicator in CTPI of TIA of Internal carotid artery system; the changes of CBF and CBV can reveal the various pathophysiological state of TIA of Internal carotid artery system.2. The hypoperfusion is one of the pathophysiological bases of TIA of Internal carotid artery system, and carotid artery stenosis and many weak vascular plaques maybe is the etiological factors of TIA of Internal carotid artery system.3. CTPI combined with CTA is important to study the etiology of TIA of Internal carotid artery system, and provides the direct and objective support for the diagnosis and treatment of TIA of Internal carotid artery system.
|
PDF Full Text Request