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1、綱臟搾患者^IX糊后鵬皺mw古作用2018-03-2910:29:58中国现代医生2018年6期王沽陈峰董海波王高燕［摘耍］鬥的研究磁共振灌注成像(PWI)及磁共振扩敗张S成像(DTI)对颈动脉狭窄患者支架植入术前后脑功能变化的评估作用。方法选取20例经脑血管造影证实的单侧颈动脉重度狹窄患者，于颈动脉支架植入术(CAS)前后行PWI、DTI检査，评估术前术后脑血流量(CBF)、脑iflL流容积(CBV)、平均通过时间(MTT)的变化以及各向异性分数(FA)的变化怙况。结果20例患者术前双侧脑灌注存在差异，患侧MTT延长，CBF、CBV降低，术后患侧MTT缩短(t=4.3
2、96,P=0.000),CBF升高(t=-2.812,P=0.011)，差摊有统计学意义；CBV变化不明显。术前患侧额叶FA值较对侧降低(t=-2.539,P=0.013),术后患侧额叶FA值较术前升高(t=-2.322,P=0.032),而顶叶、枕叶、颞叶、内囊前肢、内囊后肢FA值变化不明显。结论联合应用PWI、DTI技术可提示脑组织血流灌注及脑白质受损怙况，从而评估单侧颈动脉狭窄患者CAS术前术后脑功能的变化。［關键词］功能磁共振；颈动脉狭窄；颈动脉支架植入术：磁共振灌注成像；扩散张量成像［中图分类号］R743.3［文献标识码］B［文章编号］1673-9701(20
3、18)06-0107-05［Abstract］ObjectiveToevaluatethechangesofbrainfunctionbeforeandaftercarotidarterystentinginpatientswithcarotidstenosisbyMRperfusion-weightedimaging(PWI)andMRdiffusiontensorimaging(DTI).MethodsTwentypatientswithcarotidarterystenosiswereunderwentPWIandDTIbeforeandafterCAS.Cere
4、bralbloodvolume(CBV),cerebralbloodflow(CBF),meantransittime(MTT)andfractionalanisotropy(FA)valuesweremeasured.ResultsThereweredifferencesinbilateralcerebralperfusionbeforeoperationin20patientswithunilateralcarotidstenosis.MTTintheaffectedsidelengthened,whileCBFandCBVdecreased.AfterCAS,th
5、eMTToftheaffectedsidewasshortened(t=4.396,P=0.000),andCBFincreased(t=-2.812,P=0.011),andthechangeswerestatisticallysignificant.PreoperativefrontallobeFAwaslowerthancontralateral(t=-2.539，P=0.013),andthefrontallobeFAvaluewashigher(t=-2.322，P=0.032)thanthatbeforeoperation.TheFAvaluesofthep
6、arietallobe,occipitallobe,temporallobe,anteriorlimbofinternalcapsuleandposteriorlimbofinternalcapsulewerenotsignificantlychanged.ConclusionTheapplicationofPWIandDTIcanindicatethecerebralbloodflowperfusionandthedamageofbrainwhitematter，soastoevaluatethechangesofbrainfunctionbeforeandafter
7、CASinpatientswithunilateralcarotidstenosis.［Keywords］FunctionalMRI；Carotidarterystenosis；Carotidarterystenting；Magneticresonanceperfusionweightimaging：Diffusiontensorimaging颈动脉狭窄鉍常见的原因为动脉粥样硬化。动脉斑块的形成可使得颈动脉管腔变窄，降低颅内动脉末梢血流的灌注，且斑块内部新牛.血管脆弱，易发中破裂，引发斑块破溃、出血，从而导致脑梗死的发生［1,2］。鬥前治
