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Neuroradiology：颅内动脉支架术后预测脑高灌注的手段--FLAIR序列血管高信号

2017-07-29 shaosai MedSci原创

脑动脉支架术后脑灌注MRI
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脑动脉狭窄成形支架植入术，是临床常用的介入治疗脑动脉狭窄方法。通常局麻，经股动脉穿刺放置动脉鞘，经鞘孔通过血管成形支架输送系统，把支架放置血管狭窄部位，实现狭窄血管正常或残余狭窄率小于30%，改善该血管及其分支血流，从而缓解症状达到治疗目的。目前，尚没有文献表明在颅内动脉支架术（IAS）后能有可靠影像学表现提示脑高灌注。本研究为了评价FLAIR序列血管高信号（FVHs）即所谓的T2-FLAIR高信

脑动脉狭窄成形支架植入术，是临床常用的介入治疗脑动脉狭窄方法。通常局麻，经股动脉穿刺放置动脉鞘，经鞘孔通过血管成形支架输送系统，把支架放置血管狭窄部位，实现狭窄血管正常或残余狭窄率小于30%，改善该血管及其分支血流，从而缓解症状达到治疗目的。目前，尚没有文献表明在颅内动脉支架术（IAS）后能有可靠影像学表现提示脑高灌注。本研究为了评价FLAIR序列血管高信号（FVHs）即所谓的T2-FLAIR高信号血管征预测IAS后利用ASL提示的脑血流量（CBF）增加的价值,并将结果发表在Neuroradiology上。

本研究共回顾了16例颅内动脉支架手术前（D0）、术后1天（D1）、术后3天（D3）的ASL CBF图像和T2-FLAIR图像。将T1WI图像作为脑图来计算CBF.比较IAS前后CBF以及术后支架术区和非束区CBF的变化。将CBF升高50%定义为高灌注。评估FVHs预测高灌注的能力。

在支架植入术的血管区域、对侧大脑前、中、后动脉区域的D1 CBF值要明显高于D0CBF值，（均P < .05）。在所有血管(P < .001)、所有非支架植入血管(P < .001)和同侧PCA(P < .05)区域。在非对称性FVHs患者中CBF增高50%的比例要明显高于无FVHs表现的患者。

FVHs可作为IAS术后CBF明显升高的重要预测因子。

原始出处：

Wan CC， Chen DY， Tseng YC，  et al.Fluid-attenuated inversion recovery vascular hyperintensities in predicting cerebral hyperperfusion after intracranial arterial stenting.Neuroradiology. 2017.DOI： 10.1007/s00234-017-1863-6

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    2017-08-02 qindq

    #支架术#

    0

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    2018-02-04 liuhuangbo

    #高灌注#

    0

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    2018-06-09 gujh

    #支架术后#

    0

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    2017-10-22 jyzxjiangqin

    颅内动脉支架术后.

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2080840, encodeId=97b72080840db, content=<a href='/topic/show?id=53fa5e10578' target=_blank style='color:#2F92EE;'>#支架术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57105, encryptionId=53fa5e10578, topicName=支架术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d64f419, createdName=qindq, createdTime=Wed Aug 02 16:14:00 CST 2017, time=2017-08-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1951223, encodeId=5a0e1951223cf, content=<a href='/topic/show?id=44fd10249309' target=_blank style='color:#2F92EE;'>#高灌注#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102493, encryptionId=44fd10249309, topicName=高灌注)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6779163, createdName=liuhuangbo, createdTime=Sun Feb 04 10:14:00 CST 2018, time=2018-02-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2019251, encodeId=ddd6201925142, content=<a href='/topic/show?id=e9d25e1068b' target=_blank style='color:#2F92EE;'>#支架术后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=57106, encryptionId=e9d25e1068b, topicName=支架术后)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3333505, createdName=gujh, createdTime=Sat Jun 09 17:14:00 CST 2018, time=2018-06-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=255010, encodeId=2a9b2550102d, content=颅内动脉支架术后., beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sun Oct 22 07:24:45 CST 2017, time=2017-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1950800, encodeId=d02a1950800b1, content=<a href='/topic/show?id=20101021e97e' target=_blank style='color:#2F92EE;'>#高信号#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102179, encryptionId=20101021e97e, topicName=高信号)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=08e4137, createdName=meichuangyi, createdTime=Mon Sep 04 07:14:00 CST 2017, time=2017-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=228853, encodeId=708122885313, content=现在的患者，血管狭窄越来越多～, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/C3426ED027FF661B0C576A5B3127C2E8/40, createdBy=39dc1706090, createdName=QQ25ed180f, createdTime=Tue Aug 01 14:02:18 CST 2017, time=2017-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=227929, encodeId=9e7122e9295a, content=有意思了，涨姿势了, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLCclExeQ6LOGMD4dTsia4Ty4HtZCxRmG5vO5XIKfKX3a3vusfhHSej4Iib517vmhFW7RQgh7bpDp1yw/0, createdBy=50951609779, createdName=baihao215, createdTime=Sun Jul 30 07:29:37 CST 2017, time=2017-07-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=227893, encodeId=9fdb22e89372, content=学习了谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2017/04/21/72142930668371951a41ef4ea4b233e6.jpg, createdBy=dcbc1715228, createdName=刘煜, createdTime=Sun Jul 30 06:57:04 CST 2017, time=2017-07-30, status=1, ipAttribution=)]
    2017-09-04 meichuangyi

    #高信号#

    0

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    2017-08-01 QQ25ed180f

    现在的患者，血管狭窄越来越多～

    0

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    2017-07-30 baihao215

    有意思了，涨姿势了

    0

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    2017-07-30 刘煜

    学习了谢谢分享

    0