Whole Brain Ct Perfusion Imaging In Carotid Artery Stenosis Treatment

Objectives:Carotid Artery Stenosis is the major cause of the ischemic cerebral infarction.The operative treatment for the carotid artery stenosis is a effective method to prevent the cerebral ischemic events. The purpose of this study is to evaluate the application and meaning of whole brain CT perfusion (CTP) check in the treatment of the carotid artery stenosis. These evaluations include:1. Is the CTP scan useful to assess the treatment effect of the CEA and CAS for carotid artery stenosis? 2. To find out the differences of cerebral perfusion change between the cases after CEA or CAS. 3. To identify the association between the patients' 1-year outcomes and the cerebral perfusion statue post-operatively.Materials and methods:The carotid stenotic patients treated in our department from Aug.2009 to Jul.2010 were reviewed. Their demographic data, treatment methods, CTP results and one year outcomes were documented. The total number of the patients is 32 which includes CEA 11, CAS 21,15(47%) patients were symptomatic and 17(53%) were asymptomatic. There are 19(59%) unilateral stenosis, 8(25%) bilateral stenosis,5(16%) one side stenosis and the other side occlusion. T-test was applied to analyse the patients' perfusion statue pre and post the operation.U-test was used to analyse the patients' perfusion statue pre and post CAS or CEA respectively; multiple regression analysis was employed to analyse the association between the changing of the patients' perfusion and the one year outcome.A P value<.05 was considered statistically significant.Results:1.The rCBF (t=-5.969, P＜0.05) and rCBV (t=-5.216, P＜0.05) of patients underwent CEA and CAS were both increased while the rMTT were decreased(t=2.062,P<0.05).2. There was no difference between the post operative perfusion of the patients who underwent CAS or CEA (P>0.05).3. EQ-5D was used to analyse the patients' life changing at the one-year follow-up. The correlation coefficients for rCBF, rCBV, rMTT are 0.735,0.400,0.464 and the P=0.000,=0.023, =0.008 respectivly.Conclusions:1. CTP scan is an effective and convieniet method to evaluate the CP after the treatment for carotid artery stenosis.2. All of the patients'CTPs increased after the treatment of CAS/CEA.3. The degrees of CTPs increased have a positive correlation to the outcomes of one-year follow up.