| Background:Ischemic cerebrovascular disease (ICVD), is a group of diseases that caused by chronic cerebral hypoperfusion, including:chronic cerebral insufficiency, ischemia induced leukoaraiosis and subcortical arteriosclerotic encephalopathy, cerebral atrophy.It is a common pathological basis of many dieases, such as Alzheimer’s disease and Binswanger’s disease and so on. It was divided into three stages according to the progression:the early stage is a period of chronic cerebral insufficiency, the middle stage including TIA and cerebral infarction, the late stage is sequelae of cerebral infarction and recurrent infarction. The early onset of the disease is often mild and nonspecific and lack of the gold standard for diagnosis, so it is easy to be ignored. CTP is a kind of functional imaging can quantitatively reflect the tissue and organ blood flow, has a high sensitivity for the diagnosis of ischemic encephalopathy, it can analyze the brain function state qualitatively and quantitatively. Cerebral CTA can display the vascular morphology and quantitative measurement clearly. Combination of the two imaging can be more comprehensive response of vascular morphology and brain function in patients with ICVD.PART1Comparasion of the cerebral vascular morphology characteristic between the early stage of ICVD and normal groupsPurposeTo investigate the changes of vascular morphology characteristic of patients with ICVD compared with the normal groups, and provide more diagnostic information.MethodsPatients who completed head/head and neck CTA and head CTP examination at the same time in our hospital between 2013.10-2014.10 were included in the study. Finally a total of 25 patients were included into the experimental group. The patients who completed head/neck CTA in the same period in our hospital were included into the control group. A total of 30 cases were selected. The tortuosity index, vessel diameter and tortuosity number of the M1 segment of MCA and intracranial segment of VA were measured. The results were statistically analyzed.Results1 The tortuosity number, tortuosity index, diameter of M1 segment of MCA of experimental and control group is:1.119±0.167and 1.08±0.102 (p=0.142),3.400±0.658 and 2.832±0.342 (p=0.001),0.750±0.710 and 0.250±0.473 (p=0.001)2 The tortuosity number, tortuosity index, diameter of intracranial segment of VA of experimental and control group is:1.139±0.115 and 1.122±0.220(p=0.574),3.954+0.754 and 3.565±0.602(p=0.004),1.216 +0.702 and 0.433±0.563 (p=0.001)3 There was no significant difference between left and right side of vascular parameters of M1 segment of MCA and intracranial segment of VA (p>0.05)ConclusionThe vascular morphology changes in early ICVD patients were diameter thickening and tortuosity number increases compared with the control group. There was no statistically significant difference between the left and right side of vascular parameters of M1 segment of MCA and intracranial segment of VA.PART 2The correlation research of vascular morphology with CT perfusion parameters of early ICVDPurposeTo study the correlation between the morphological characteristics of M1 segment of MCA and intracranial segment of VA and perfusion parameters, and so we can provide information for the early diagnosis of early ICVD.MethodsThe object is the 25 patients of ICVD in part 1. Measurement of vascular parameters are the same as part 1. Method of measured the CTP parameters:according to the brain blood supply area, select the supply area of brain tissue of M1 segment of MCA and intracranial segment of VA, measurement of perfusion parameters:CBF, CBV, MTT, Tmax and TTP. Statistical analyzed the correlation between vascular parameters and perfusion parameters; subtraction was taken between the vascular tortuosity index, diameter, tortuosity number and the perfusion parameters of left and right sides, then analyzed the correlation between the difference value; use the vascular parameters as the grouping basis, then statistical analyzed the perfusion parameters between groups.Results1 The correlation coefficient between the tortuosity index of Ml segment of MCA and the CBF、CBV、MTT、TTP、Tmax is: 0.021(p =0.881) ,-0.129(p =0.361) , -0.242(p =0.084) , 0.117(p =0.409) ,-0.208)( p=0.139) ; the correlation coefficient between of vascular diameter and the CBF、CBV、 MTT、TTP、Tmax is:-0.058(p =0.685) , 0.213 (p =0.130) ,0.222(p =0.113) ,-0.081 (p =0.567) , 0.243 ip =0.082) ; The correlation coefficient between the tortuosity number and the CBF、 CBV、MTT、 TIP、Tmax is:-0.043(p =0.764) , -0.204(p =0.146) ,-0.185 (p=0.189),-0.053 (p =0.707),-0.118(p=0.406)The correlation coefficient between the tortuosity index of intracranial segment ofVA and the CBF>CBV、MTT、TTP、Tmax is: 0.103(p=0.470), 0.051 ip =0.719) , 0.015 (p =0.917),-0.065 ip =0.646) , -0.083 ip =0.558) ; The correlation coefficient between the vascular diameter and the CBF、CBV、MTT、TTP、Tmax is: -0.021(p=0.884),-0.100 ip =0.482 ),-0.145(p =0.306) ,0.034(p =0.808),-0.228(p =0.104); The correlation coefficient between the tortuosity number and the CBF、CBV、MTT、TTP、 Tmaxis:-0.032(p=0.824) , -0.202(p =0.151),-0.056(p=0.691) , -0.141 (p=0320) ,-0.127(p =0.371)2 Use the tortuosity number as the group basis, the Ml segment of MCA of group A has 0 bending, group B has 1 or 2 tortuosity, the CBF、 CBV、MTT、TTP、Tmax of each group is:20.75± 5.54 and 20.89±4.91 (p =0.934), 1.98±0.42 and 1.91±0.29 (p=0.469) , 8.45 ±1.76 and 7.84 ±1.31(p =0.185), 10.96±1.81 and 10.35±2.94 (p=0.450),4.49±0.91 and 4.08±1.12 (p =0.193); the intracranial segment of ⅣA of group A has 1 or 2 tortuosity, group B has 2 or 3 bending, the CBF> CBV、MTT、TTP、 Tmax of each group is: 16.56±6.07 and 16.13±5.41 (p =0.792) , 1.96 + 0.59 and 1.71±0.40 (p =0.075) ,9.76±2.32 and 8.81 ±1.77 (p =0.073) , 12.11±1.50 and 11.11±2.01 (p =0.073),5.10±1.45 and 4.44±1.37 (p =0.109) .Use the median of tortuosity index (MCA is 1.051, ⅣA is 1.101) as group basis,the perfusion parameters were divided into two groups, the CBF、CBV、MTT、TTP、Tmax of MCA of each group is:20.94+4.82 and 20.76±5.30 (p =0.898),2.01±0.36 and 1.88+±.29(p =0.152) ,8.39 ±1.68 and 7.84±1.43(p =0.205) , 10.67±2.05 and 10.62±2.95(p =0.941), 4.36±1.12 and 4.17±1.01 (p =0.521); the CBF、CBV、MTT、 TTP、Tmax of intracranial segment of VA of each group is: 15.86±5.42 and 16.95±6.19 (p =0.502) ,1.82±0.53 and 1.91±0.55(p =0.527),9.37 ± 1.91 and 9.39±2.46(p =0.965) , 12.02±1.66 and 11.46±1.83 (p =0.247) ,5.12±1.04 and 4.60 ±1.74 (p=0.197)Use the median of vascular diameter (MCA is 3.45mm, VA is 3.95mm) as group basis,the perfusion parameters were divided into two groups, the CBF、CBV、MTT、TTP、Tmax of MCA of each group is:21.41 ±0.28 and 20.36 ±0.78 (p=0.440), 1.92±0.30 and 1.97±0.36(p =0.561), 7.74±1.67 and 8.50±1.39 (p=0.080) , 10.31±1.98 and 10.97±1.95(p =0.450) , 3.93 ±0.26 and 4.23±0.48(p=0.093); the CBF、CBV、MTT、 TTP、Tmax of intracranial segment of VA of each group is:16.70± 5.49 and 16.11+6.17 (p =0.716) , 1.97±0.49 and 1.77±0.58 (p =0.185) , 9.86 ± 2.39 and 8.89 ±1.87 (p =0.110) , 11.72±1.78 and 11.76±1.77(p =0.945) , 5.14±1.57 and 1.58±1.27 (p =0.170)Conclusion1 There is no significant correlation between the vascular parameters and the perfusion parameters of Ml segment of MCA and the intracranial segment of VA2 The parameters has no significant difference between groups, when use the vascular parameter as the basis of group. |
PDF Full Text Request