Changes in cerebral CT perfusion after carotid endarterectomy / 中华放射学杂志

ABSTRACT

Objective To find the sensitive parameters for evaluating the cerebral CT perfusion changes in patients before and after carotid endarterectomy(CEA).Methods Between November 2015 and April 2017,the data of 27 patients who underwent CEA and conducted CT perfusion(CTP) examination before and after the operation were analyzed retrospectively.The different perfusion parameters of the cerebral hemisphere in different areas were analyzed before and after the operation.Absolute perfusion parameters includecerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT) and time to peak(TTP);relative perfusion parameters includerCBV,rCBF,rMTT and rTTP;relative to brainstem perfusion parameters includesCBV, sCBF, sMTT and sTTP.Paired sample t test (normal distribution of quantitative data) was used to analyze the parameters differences before and after the operation.Results The postoperative perfusion parameters of the operated side cerebral hemisphere compared with the preoperative(1)The absolute perfusion parametersthe decreased of TTP in frontal lobe,anterior watershed region,middle cerebral artery territory and basal ganglia region[preoperative(22.4 ± 3.0)s,(23.0 ± 3.1)s, (23.2±2.2)s,(21.9±2.7)s,postoperative(20.1±2.4)s,(20.5±2.7)s,(20.7±2.8)s,(19.5±2.8)s]had statistical significance(t values were 2.437, 2.504, 2.882, 2.431, P<0.05).(2)The relative perfusion parametersthe decreased of rMTT in middle cerebral artery territory and basal ganglia region(preoperative 1.18±0.44,1.06± 0.22,postoperative 1.04±0.33,0.97±0.16)and the decreased of rTTP in middle cerebral artery territory and basal ganglia region(preoperative 1.07±0.15,1.04±0.05,postoperative 1.00±0.13,0.97±0.06)had statistical significance(t values were 2.235, 2.244, 2.245, 2.268, P<0.05).(3)The relative to brainstem perfusion parametersthe decreased of sCBV in middle cerebral artery territory(preoperative 1.08±0.16,postoperative 0.98 ± 0.15), the increased of sCBF in frontal lobe and middle cerebral artery territory(preoperative 1.07 ± 0.19, 1.00 ± 0.21,postoperative 1.17 ± 0.21, 1.09 ± 0.20),the decreased of sMTT in middle cerebral artery territory and basal ganglia region(preoperative 1.27±0.29,0.94±0.11,postoperative 1.05±0.05,0.86±0.10), the decreased sTTP in frontal lobe,anterior watershed region,middle cerebral artery territory and basal ganglia region(preoperative 1.05±0.05,1.07±0.06,1.10±0.08,1.02±0.03,postoperative 0.97±0.05,0.96± 0.06,0.98±0.07,0.95±0.01)had statistical significance(t values were 2.882,-2.995,-2.737,2.172,2.425, 2.249, 2.263, 2.806, 3.267, P<0.05). Conclusion CTP is significant to evaluate the changes of cerebral perfusion in patients who underwent CEA. The relative to brainstem parameters are more valuable than relative parameters and absolute parameters in judging the perfusion changes after CEA.