CTP In Front Of Carotid Artery Stenosis Stent Angioplasty Evaluation Value

As people living standard enhancement and the development of modern industry,more than malignant tumor stroke,myocardial infarction,become the first cause of death in our country,and the most common cause of disability.Among them,ischemic stroke is about 75 ~ 85% of the total occupied.According to the data show that in over 60 years old crowd,neck artery stenosis occurrence probability is 0.5%,and 80 years of age or older population is about 10%.Neck artery stenosis can lead to the lack of blood supply of the brain,brain significantly reduced or even vascular occlusion is one of the important causes of cerebral infarction.Actively treating cervical artery stenosis can effectively enhance the quality of life of patients,and alleviate the burden of the family and society,thus highlights the important research significance.Objective: through to the CT cerebral perfusion imaging(CT brain perfusion,CTP)parameters in severe symptomatic internal carotid artery stenosis stenting before and after the change,before the surgery and the study of CT cerebral perfusion imaging for preoperative to be assessed.At the same time,the analysis with its application value.Methods: Based on surgery before detection of CTP,the examination of 58 cases of patients with internal carotid artery stenosis was more than 70% of the patients specific divided into low perfusion group(27 cases)and normal perfusion group 31 cases,the review of CTP after 3 months after the operation,than before the operation and after each relative perfusion parameters,mainly regional cerebral blood volume(CBV R),local reach peak time(r TPP),regional cerebral blood flow(rCBF)and local average by MTT(R)to change the phenomenon,and at the same time were compared between the 2 groups after surgery clinical treatment effect.Results: Preoperative perfusion abnormalities of patients with TTP side indicators appeared sluggish,on one side and healthy side indices of perfusion parameters can be found after compared them,one side of CBF index is average(61.1 + 9.8),is the healthy side of average(63.3 + 10.1);CBV index is the average value of side(35.9 + /-3.9),the contralateral(36.9 + 3.7)is the average value;One side of the TTP index average(118.4 + 19.2),the contralateral(99.9 + 11.9)is the average value.Visible,on both sides of the value of CBF and CBV and no significant statistical significance(P > 0.05),and patients with narrow lateral TTP exist hysteresis(P < 0.001).Artery stenosis degree and the side of the patients with various parameters of the numerical rank test,the results showed that the degree of arterial stenosis and CBF,CBV doesn't exist intrinsic relevance(P > 0.05),but there were positive correlation,the correlation of the TTP,and the correlation value is 0.587.Compared with the preoperative,postoperative mortality in patients with low perfusion group r CBF,r determined by MTT,and r the TPP indicators are significantly improved,there are obvious difference(P < 0.05)r CBV no significant statistical difference(P > 0.05),and normal perfusion in postoperative and preoperative relatively,r CBV,CBF r determined by MTT,r the TPP and r indicators such as there is no statistical difference(P > 0.05).Two groups in postoperative follow-up showed that patients with low perfusion group postoperative risk of ischemic stroke and TIA and normal low perfusion group compared with patients(P < 0.05),and postoperative m RS is not more than 2 points(that is,the evaluation for good prognosis)was a marked increase,with statistical significance.Normal perfusion group of patients after surgery,the occurrence probability of TIA and ischemic stroke was 9.4%(3/32).Low perfusion group of patients after surgery,the occurrence probability of TIA and ischemic stroke was 7.7%(2/26).After surgery,the hair between the 2 groups of patients with TIA and ischemic stroke risk there is statistical significance(P < 0.05),which means that the neck artery stent angioplasty in patients with preoperative low perfusion in prevention of TIA and ischemic stroke benefit more.Internal mRS before surgery,2 groups of patients no significant statistical difference significance(P > 0.05),among them,low perfusion group of patients after surgery of mRS for no more than 2 points(i.e.,the prognosis is good state)ratio is higher,at the same time,there is an obvious increasing number compared with before operation,there is statistical significance difference(P < 0.05),which means that patients with low perfusion group after cranial bracket forming in the surgery,the nerve function can be improved.Patients with normal perfusion group mRS no more than 2 points(i.e.,the prognosis is good state),and the number before surgery has no significant statistical significance of difference(P > 0.05),showed that normal perfusion group of patients after accepting stent angioplasty of nerve function,there is no significant improvement.Bracket forming operation is completed,degree of neural function in patients with low perfusion group improved better than patients with normal perfusion group(92.3% VS75.0 %),there is statistical significance difference(P < 0.05).Conclusion: before the operation,there is a patient of cerebral low perfusion zone after perfusion operation performed on intracranial vascular stent forming after the surgery,to be significantly improved,but before the operation of brain blood flow perfusion in patients with normal after the operation did not appear significant therapeutic effect.The operation has obvious effect on improving the neural function of low perfusion group patients forming stent cranial,can avoid ischemic events.Therefore,CTP can accurately reflect the stent patients before and after treatment hemodynamic the change consequences,before the operation should be improved the effect of vascular CTP review,through clinical studies have shown,for severe symptomatic craniocervical atherosclerotic stenosis of the treatment of surgery before the evaluation,with can not be ignored in the clinical value.