The Relationship Between The Pattens Of Collateral Circulation And Cerebaral Hemodynamics Of The Patients With Severe Internal Carotid Artery Stenosis Or Occlusion

Study purpose:Choose those who have undergone cerebral angiography (DSA)and brain MRI perfusion and diagnosed with unilateral internal carotidartery stenosis or occlusionwere analyzed retrospectively, to explore theestablishment of collateral circulationand its relationship with cerebralhemodynamics.Study methods:Collect patients in2008January to2014year December in JapanUnion Hospital of Jilin University who undergone cerebral angiography(DSA) and brain MRI perfusion, choose21patients who was diagnosedwith severe stenosis or occlusion of unilateral internal carotid artery(stenosis rate greater than70%). Grouped according to DSA imagediagnosis of collateral circulation open form, the primary collateralcirculation group (primary group) including the conditions of anteriorcommunicating artery opening, posterior communicating artery opening,and anterior, posterior communicating artery common opening;secondary collateral circulation appeared group (Group secondary) including the emergence of ophthalmic artery open, leptomenigeal collateralbrunches, and the primary collateral circulation and secondary collateralcirculation appearations together. Treatment for each patient PWI images,select three consecutive levels, respectively, frontal lobe near cortex level,coronal radiation level, basal ganglia level, images are to avoid largevessels, the internal carotid artery blood supply in the region ofsymmetric selected region of interest (ROI). Were recorded in threeconsecutive patients with lesions in each level of ipsilateral andcontralateral PWI parameters (TTP, MTT, CBV and CBF) value, andcalculated ratio of the ipsilateral to contralateral side of the above fourparameters and the ratio, namely: rTTP, rMTT, rCBF, rCBV.The results of the study1．Overall and at each level, compare the CBF and CBV, MTT, and TTPvalues between vascular lesions and the opposite side. We compare theCBF in general vascular lesions and vascular lesions of the lateral we getP=0.764, there is no statistically significant difference From thecomparison of CBV between vascular lesions and vascular lesions of thelateral,we get P<0.001, there is a statistically significant difference.According the comparison of MTT、TTP between the vascular lesionlateral and contralateral, there were statistical differences in twoparameters. We get P<0.001both. At three different levels of analysisdata, the comparison of CBF between vascular lesions and contralateral at three levels, their differences were not statistically significant, howeverthree parameters CBV、MTT、TTP were compared between vascularlesions and contralateral at different levels showed statisticaldifferences.2. The comparison of rCBV between patients with internal carotid arteryocclusion and the patients with internal carotid artery stenosis. We getthat the p-value is less than0.05, the difference was statisticallysignificant. The comparison of rCBF between the patients with nternalcarotid artery occlusion and the patients with internal carotid arterystenosis,we get p-value is greater than0.05,the difference was notstatistically significant.The comparison of rMTT、rTTP in patients withinternal carotid artery occlusion between the patients with internal carotidartery stenosis,we get the p-value is less than0.05, the difference wasstatistically significant.3. The comparison of rCBF in patients with primary and secondarycollateral circulation group in three dimensions, we get that the p-value isgreater than0.05, there is no statistically significant difference. Comparethe rCBV of primary collateral circulation and secondary collateralcirculation group in the three levels, p-value less than0.05and thedifference was statistically significant.rMTT, rTTP at three levels havebeen compared between the primary collateral circulation and secondarycollateral circulation group, we get that p-value is less than0.05, the difference was statistically significant..The study conclusion:1. Compare the vascular lesion side with the contralateral side of thepatients with Unilateral internal carotid artery severe stenosis orocclusion,the hemodynamic of the vascular lesion side is abnormal.2.The possibility of the severe cerebral hemodynamic impairment ofthe patients with the internal carotid artery occlusion is larger than thepatients of internal carotid artery stenosis3.The possibility of hemodynamics impairments of the patients withthe secondary collateral collations is higher than the patients with thesecondary collateral circulation.