Quantitative analysis of vascular permeability surface area product in patients with intracranial atherosclerotic stenosis with whole brain CTP / 中国医学影像技术

ABSTRACT

Objective: To observe vascular permeability surface area product (PS) and hemodynamic status of brain tissue in patients with intracranial atherosclerotic stenosis (ICAS) and the changes after stent implantation with whole brain computed tomography perfusion (CTP). Methods: Totally 59 patients with ICAS (implantation group)and 16 volunteers(control group) were collected. All subjects underwent whole brain CTP, and 17 ICAS patients among them underwent responsible vascular stent implantation. Quantitative analysis software was used to measure vascular PS, hemodynamic parameters (cerebral blood flow [CBF], cerebral blood volume [CBV] and mean transit time [MTT]) in the responsible artery blood supply area, and the healthy side mirror values were obtained. The differences of vascular PS and hemodynamic parameters were compared between 2 groups. The changes of vascular PS and hemodynamic parameters before and after stent implantation in ICAS group and the correlations of vascular PS and hemodynamic parameters were analyzed. Results: Compared with control group, ICAS group had higher vascular PS value, lower CBF and longer MTT (t=7.77, -4.84, 7.47, all P<0.05). Compared with the healthy side, increased vascular PS value, decreased CBF, increased CBV and MTT were observed on the affected side in ICAS group (t=-4.38, -4.48, 4.49, 8.35, all P<0.05). After stent implantation, statistical differences of vascular PS value, CBF, MTT of the affected side were found compared with those before (t=0.95, -4.05, 3.50, all P<0.05). There was slight negative correlation between PS value and atrial fibrillation (P<0.05). Vascular PS was highly and moderately positively correlated with MTT and CBV, respectively (r=0.86, 0.59, both P<0.05), and negatively correlated with CBF (r=-0.31, P<0.05). Conclusion: Vascular PS value can be used as an imaging marker to quantitatively evaluate the therapeutic effect of ICAS. Vascular PS value of the affected brain tissue of ICAS patients increased significantly, but significantly decreased after stent implantation. Vascular PS value combined with hemodynamic parameters can more accurately reflect the pathophysiological changes of brain tissue, therefore providing references for individualized treatment of ICAS and evaluation of efficacy.