磁共振灌注成像(PWI)结合DSA评价动脉瘤性蛛网膜下腔出血后脑血管痉挛的临床分析-外科学(神经外科)专业论文.docx

第三军医大学硕士学位论文 第三军医大学硕士学位论文 PAGE PAGE 4 age of 55 ± 10.6 years, DSA result no cerebral vasospasm and angiostenosis. All the patients were 7±2d after subarachnoid hemorrhage when admission, and all were detected with DSA and PWI in 24 hours. According to diagnostic criteria of cerebral vasospasm, on the basis of the result of DSA, all the patient divided into mild, moderate and severity spasm group. By contrast the brain perfused parameter differences of PWI examine among all groups , the parameters include relative cerebral blood flow(rCBF）, relative cerebral blood volume (rCBV）， mean transit time (MTT)， time to peak(TTP). All patients according to clinical symptoms into symptomatic cerebral vasospasm group (sCVS) and non- symptomatic cerebral vasospasm group (nsCVS), compared with control group, PWI check the parameters of the correlation analysis. These data are expressed as the means±SEM. Kruskal-Wallis H test and Spearman level relevant were used for multiple groups analysis, P value of less than 0.05 was considered significant. The statistical package SPSS 13.0 for Windows was used for the statistical analysis. RESULTS: DSA results manifest that there is 28 cases at least one cerebral vascular spasm in extraordinary 38 patients, include mild 9 cases, moderate 10 cases, severity 9 cases ；10 cases was not CVS. The perfused parameters of extraordinary 38 patients such as rCBF and rCBV decreased in the region blood-supply by ACA、MCA、BSGL compared with control group, and there are significant differences (p＜ 0.05 ~ 0.01) ；According to the degree of vascular spasm form mild to severity spasm group the rCBF 、 rCBV in the region blood-supply of each vessels have different decline. Compared with control group, form mild to severity spasm group the rCBF、rCBV have different extended in the region blood-supply by ACA、MCA、BSGL, and the more CVS heavier, the change more obvious, and there are significant differences meaning in moderate and severity spasm group (