CT perfusion imaging and CT angiography in diagnosis of transient ischemic attack of internal carotid artery system
10.3760/cma.j.issn.1671-8925.2014.01.011
- VernacularTitle:CT灌注成像联合CT血管造影在颈内动脉系统短暂性脑缺血发作中的应用研究
- Author:
Yan ZHAO
1
;
Dingbo TAO
Author Information
1. 内蒙古自治区人民医院神经内科
- Keywords:
Internal carotid artery;
Transient ischemic attack;
Computerized Tomography perfusion imaging;
Computerized tomography angiography
- From:
Chinese Journal of Neuromedicine
2014;13(1):50-56
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the changes of regional cerebral blood flow and blood-supply artery and study the value of computerized tomography perfusion imaging (CTPI) and computerized tomography angiography (CTA) in the clinical diagnosis of transient ischemic attack (TIA) of internal carotid artery system to further explore the etiological factors and pathophysiological mechanism of TIA of internal carotid artery system.Methods Thirty-five patients with TIA of internal carotid artery system,admitted to our hospital from April 2008 to January 2009,were enrolled into patient group,and 22 healthy subjects without TIA of internal carotid artery system symptoms and negative CTA features were enrolled as control group.These patients were examined with 16 slice CTPI and CTA in head and neck within 48 h of onset; the mean transmit time (MTT),cerebral blood flow (CBF) and cerebral blood volume (CBV) in the region of interests (ROIs) between the two sides of the patient group and between patient group and control group were analyzed,and the relationship with CTA features and clinical manifestations were discussed.Results Twenty-eight of 35 patients (80％) with TIA of internal carotid artery system revealed abnormal perfusion regions corresponding to clinical symptoms in CTPI,of which there were 28 revealing abnormal perfusion regions on MTT maps,23 on CBF maps,and only 15 on CBV maps.Other 7 patients showed normal results in CTPI.The correspondence relationship between CTPI and CTA abnormality had the following 4 types:(1) there were 25 patients (71％) with perfusion abnormalities accompanied by abnormal vascular supplying the abnormal perfusion region (convict vascular); among them,16 had carotid artery stenosis,13 had many weak vascular plaques,and 6 had carotid artery dysplasia; the coexistence of a number of factors and situation existed.(2) There were 3 patients (9％) with perfusion abnormalities in CTPI but without abnormal vascular in CTA.(3) There were 3 patients (9％) with abnormal vascular in CTA but without perfusion abnormalities in CTPI.(4) There were 4 patients (11％) had neither abnormal vascular nor perfusion abnormalities.Conclusions 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.The hypoperfusion is one of the pathophysiological bases of TIA of internal carotid artery system,and carotid artery stenosis and many weak vascular plaques may be the etiological factors of TIA of internal carotid artery system.CTPI combined with CTA is important to study the etiology of TIA.
