| PART1 The research of color-coded digital subtraction angiography in the normal cerebral hemodynamic parametersObjective:The purpose of this study was to investigate the value of color-coded digital subtraction angiography(iFlow)in the study of normal cerebral hemodynamic parameters,so as to set up parameter for normal cerebral hemodynamic.Methods:From March 2013 to September 2016,We retrospectively analyze a total of 60 patients in wuhan general hospital.These patients were reexamined with DSA due to follow-up for postembolization with aneurysms by bare coils,and were suspected as intracranial vascular diseases but found normal in DSA.In order to measure the time to peak(TTP)of contrast medium in region of interest(ROI).we set the ROI at these rigion:ROI-1:internal carotid artery bifurcation;ROI-2:cerebral middle artery bifurcation;ROI-3:the middle of superior sagittal sinus;ROI-4:torcular herophili area;ROI-5:the end of basilar artery.Results:The TTP of ROI-1 to ROI-4 in left internal carotid artery angiography and ROI-5 in left vertebral artery angiography are(2.70±0.37)s?(2.85±0.36)s?(7.98±1.54)s?(8.85±1.77)s?(3.02±0.58)s respectively.The TTP of ROI-1 to ROI-4 in right internal carotid artery angiography and ROI-5 in right vertebral artery angiography are(2.77±0.35)s?(2.87± 0.36)s?(8.01 ±1.14)s?(8.77±1.26)s?(3.06 ± 0.55)s respectively.Conclusion:The technique of color-coded digital subtraction angiography provides a reference value in normal cerebral hemodynamic,and set up a novel method in the research of cerebral hemodynamic.PART2 The research of color-coded digital subtraction to the cerebral vasopasam after perimesencephalic nonaneurysmal subarachnoid hemorrhageObjective:Using the technology of color-coded digital subtraction to evaluate the hemodynamic parameters change of the cerebral vasospasm after perimesencephalic nonaneurysmal subarachnoid hemorrhage.Method:Analyzing retrospectively 60 patients who were diagnosed as perimesencephalic nonaneurysmal subarachnoid hemorrhage by CT examination and repeat DSA examination.Take these 60 patients as study group.Taking 60 patients who were reexamine for postembolization with bare coils for aneurysms,and clinical suspicion of intracranial vascular diseases with normal angiography findings as the control group.We analyzed the data of angiography of control group and study group with iFlow(DSA machine,siemens)to make a measurement and comparison of the same-part TTP(time to peak)and vascular diameter of bifurcation of bilateral internal carotid artery,bifurcation of bilateral middle cerebral artery,bilateral vertebral artery angiography in the end of basilar artery respectively.Results:Compared with control group,the TTP of the end of left vertebral artery-basilar artery(first-visit angiography)is higher,and the difference is statistically significant.(P<0.05).While for the reexamination angiography,the TTP of end of bilateral basilar artery,right internal carotid bifurcation and right cerebral middle artery bifurcation are higher than that of control group.The differences of above are statistically significant(P<0.05).Compared with the TTP of first-visit angiography,all TTP are higher,especially for the end of basilar artery and the difference is statistically significant(P<0.05).Compared with the control group,the diameter of the bilateral vertebral artery angiography in the end of basilar artery decreases when the reexamination angiography were performed.The difference is statistically significant(P<0.01).Compared with the first angiography,the diameters of the bilateral vertebral artery angiography in the end of basilar artery,left internal carotid bifurcation and left cerebral middle artery bifurcation decrease when the reexamination angiography were performed.The difference is statistically significant(P<0.01).Conclusion:Vasospasm occurs in perimesencephalic nonaneurysmal subarachnoid hemorrhage patients,mostly in basilar artery.It is proved feasible and economical to monitor the hemodynamic change of cerebral vasospasm after non-aneurysm perimesencephalic nonaneurysmal subarachnoid hemorrhage,with the method of iFlow's quantitative evaluation. |
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