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[objective]To study effect of cerebral blood perfusion and cognitive function of carotid artery stenting com-bined with medical therapy for patients with severe internal carotid stenosis.[Methods]124 patients with severe internal ca-rotid stenosis from June 2014 to June 2016 were divided into observed group and the treatment group,The treatment group given pure medical therapy,observation group given carotid artery stenting combined with medical therapy.One year follow-upr,cerebral blood flow perfusion,cognitive function,adverse events were compared between two groups.[Result]The ob-servation group rTTP,rMTT,rCBV,rCBF were significantly lower than treatment group(P<0.05,P<0.01);MMSE,MoCA score were significantly higher than treatment group(P<0.05);Vascular Occlusion,vascular restenosis,cerebral ischemic stroke,transient cerebral ischemia were significantly lower than treatment group(1.61% vs 11.29%,4.84% vs 19.35%, 1.61% vs 14.52%,4.84% vs 17.74,P<0.05).[Conclusion]Carotid artery stenting combined with medical therapy help to improve cerebral blood flow perfusion in patients with severe internal carotid stenosi,improve cognitive function,and pre-vent adverse events.
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Objective To explore the value of magnetic resonance perfusion imaging of 3D arterial spin labeling(3D-ASL)in the diagnosis of transient ischemic attack(TIA).Methods 78 of patients were diagnosed TIA on MR routine scan [T1 WI,T2 WI,T2-FLAIR,diffusion weighted imaging(DWI)],magnetic resonance angiography(MRA)and 3D arterial spin labeling(3D-ASL).The re-sult were analyzed by Chi-square test.Results In 78 patients,the abnormal routine scan was 0 case(0%);abnormal MRA 41 cases (52.6%);abnormal 3D-ASL 47 cases(60.2%);combination with each other were 60 cases(76.9%).29 cases with artery stenosis and abnormal ASL,12 case with artery stenosis and normal ASL,19 cases with normal vascular and abnormal ASL,18 cases with normal vascular and normal ASL.Conclusion 3D-ASL is better than routine magnetic resonance sequences in the diagnosis of TIA,which is convenient and should be a routine scanning sequence of TIA.3D-ASL,MRA and DWI have their own advantages and disadvantages, combination use can improve the diagnosis accuracy of TIA.
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Objective To investigate the frequency of lesions detection in patients with cerebral infarction (CI) with SPECT/CT. To investigate fluctuation of regional cerebral blood flow (rCBF) and its relationship with clinical symptoms. Methods Sixty-seven CI patients without cerebellar lesion were randomly selected. The rCBF in the regions of interest (ROI) was examined by SPECT/CT, which was collected from the frontal lobe, temporal lobe, parietal lobe, occipital lobe, thalamus, basal ganglia and cerebellum. The rCBF index was calculated. The association between fluctuation of rCBF index and clinical symptoms of patients was explored. Results There were 251 positive regions in all viewing regions , the total positive rate was 31.2%. The left side was 38.1%, while the right side was 24.4% (χ2=17.522,P 0.05). However, the average rCBF on the left parietal lobe was lower (P 0.05). rCBF≥0.7 is a clinical sign of abnormal ROI. Conclusion 30% of ROI of CI patients have lesions and the positive rate of the left side was higher. The biological rCBF values of all lobes were different. Therefore, rCBF index could be used to reflect whether the ROI is normal. rCBF≥0.7 could be used as a sign to quantitatively assess abnormal ROI in clinical practice.
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Objective Toinvestigatethechangesofcognitiveimpairmentandcerebralhemodynamics inpatientswithacutelacunarcerebralinfarctionwithin2weeksafteronset.Methods Nineteenpatients with lacunar cerebral infarction (a patient group)were consecutive enrolled in the study. Twenty-three sex-and age-matched inpatients without ischemic cerebrovascular disease or healthy volunteers of outpatient department over the same period were used as a control group. The cerebral hemodynamic features were evaluated with transcranial Doppler (TCD)breath-holding test and single photon emission computed tomography (SPECT)resting + adenosine stress imaging. Simultaneously,the neuropsychological tests were performed,the Montreal cognitive assessment (MoCA)was performed including executive capacity, structural capacity,memory (including auditory memory,visual memory,and logic memory ),information processing speed,and visual-spatial ability. Results (1 )There were no significant differences in the years of education,hypertension,diabetes,hyperlipidemia,coronary heart disease,and smoking between the 2 groups (all P>0. 05). Compared with the control group,there were significant differences in the MoCA score,visual memory,executive function,structural capacity,and information processing speed of the patient group (all P<0. 05). (2)19 patients completed the SPECT resting + load test (12 in the control group and 7 in the patient group). There were significant differences in the uptake ratio (UR)in the right basal ganglia (8. 91[-2. 48 - 5. 87]and -6. 21 [-10. 39 - 5. 42 respectively])and left frontal lobe UR (11. 62 [2. 93-16. 87]and 1. 04 [-10. 17- 3. 82]respectively)between the patient group and the control group (P<0. 05). (3)26 patients completed the breath-holding test + head-up tilt table test (n=13 in each group]. The vascular motor reactivities were 13 ± 5 on the left and 21 ± 7 on the right, and the breath-holding indexes were 0. 66 ± 0. 26 on the left and 1. 0 ± 0. 4 on the right in the patient group;the vascular motor reactivities were 24 ± 11 on the left and 30 ± 9 on the right,and the breath-holding indexes were 1. 21 ± 0. 57 on the left and 1. 5 ± 0. 4 on the right in the control group. There were significant differencesbetweenthe2groups(P<0.05).Conclusion Attheearlystageoflacunarinfarction,the patients have presented varying degrees of cognitive impairment and the changes of cerebral hemodynamics.
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ObjectiveTo explore the clinical and epidemiological value of semi-quantitative regional cerebral blood flow(rCBF)imaging in children with school phobia. Methods A total of 20 cases diagnosed with school phobia were examined with rCBF.Twelve were males and the other 8 were females.The mean age was(14.2?2.1)years(11-18 years).Semi-quantitative analysis methods were used to investigate the correlations among gender,age and rCBF. ResultsThere were significant differences in the rCBF of right fronto-parietal lobe,right occipital lobe,caput and putamen,left thalamus and hippocampus,and temporo-occipital lobe between males and females(P0.05).Only the PI of left temporo-parietal lobe of those ≥ 15 years old was significantly different from that of those
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AIM: To observe the early changes of local cerebral blood supply in dogs during the acute vertebral artery stenosis by 99 TcmECD cerebral blood flow perfusion imaging(CBFPI).METHODS: Twenty-four dogs were randomized into groups of normal controls(A),moderate stenosis(B),severe stenosis(C) and arterial occlusion(D),with 6 in each group.Group A were free from any intervention,but Group B,C and D were undergone ligation of the right vertebral arteries by the extent of 50%～69%(Group B),70%～99%(Group C) or 100%(Group D).The imaging agents were injected intravenously 0.5-1 h after ligation and the single photon emission computed tomography(SPECT) was performed after 1 h.RESULTS: CBFPI examination of the early changes of cerebral blood supply during the acute vertebral artery stenosis by visualization showed that the sensitivity was 33.3%,83.3% and 100% in Group B,C and D,respectively,with an average sensitivity of 72.2%,while semi-quantitative assessment suggested that the sensitivity was 50%,100% and 100% in the three groups,respectively,with an average sensitivity of 83.3%.When examining the activity ratio for regions of interest(ROI) by semi-quantitative 99 Tcm-ECD CBFPI,the findings suggested that Group D and C decreased significantly(exception in cerebellum in Group C),but Group B had no evident changes,as compared with Group A.By comparison of the groups of B-C,B-D and C-D,differences were observed in the right temporal lobes,whereas the changes in left temporal lobes were seen in Group B-C or B-D.The changes were seen in occipital lobes when groups of B and D were compared,but with no differences in cerebellum.CONCLUSION: The degree of stenosis in vertebral arteries may involve varied regions,the temporal lobe is susceptive,followed by occipital lobe,while cerebellum is somewhat resistant from the involvement.