306 Th Hospital of Peoples Liberation Army

Beijing, China

306 Th Hospital of Peoples Liberation Army

Beijing, China

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Du J.,306 Th Hospital of Peoples Liberation Army | Cai Y.,306 Th Hospital of Peoples Liberation Army | Wu Z.,306 Th Hospital of Peoples Liberation Army | Cui Y.,306 Th Hospital of Peoples Liberation Army | And 2 more authors.
Chinese Journal of Cerebrovascular Diseases | Year: 2015

Objective To investigate the relationship between the evaluation of cerebral |>erfusion with CT perfusion (CTP) imaging and cognitive impairment in patients with asymptomatic severe internal carotid stenosis. Methods A total of 104 patients with asymptomatic severe unilateral internal carotid artery origin stenosis (the unilateral stenosis rate 70% and the contralateral stenosis rate <30% ) were enrolled respectively. After conducting Montreal Cognitive Assessment (MoCA) scores, they were divided into a non-cognitive impairment group (n =24; MoCA 5=26) and a cognitive impairment group (n =80; MoCA <26). All patients were performed digital subtraction angiography ( DSA) and/or CT angiography (CTA) examinations. Their unilateral severe stenosis was confirmed, and they underwent brain CTP examinations. The relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBF), relative mean transit time ((rMMT)), and relative time to peak (rTTP) were calculate by CTP. The presence rate of collateral circulation in 96 patients was calculated by DSA. The presence rate of collateral circulation, and relative perfusion parameters of the 2 groups were compared. Results (1) The MoCA score in patients of the non-cognitive impairment group was 27. 8 ± 1.7, and the MoCA score in patients of the cognitive impairment group was 21. 4 ± 3. 1. There was significant difference between the 2 groups (t = 17. 959, P <0.05). (2) The rate of 96patients having collateral circulation was 68. 4% (52/76) in the cognitive impairment group,and in the non-cognitive impairment group was 60.0% (12/20). There was no significant difference (P >0.05). The CTP parameters (rMMT), (rTTP), rCBV, and rCBF in the non-cognitive ini|>airnient group were 1. 074 ± 0. 066, 1. 103 ±0. 032,1. 045 ± 0. 021 and 1. 066 ± 0. 040, respectively; the CTP parameters rM'IT,(rTTP),rCBV,and rCBF in the cognitive impairment group were 1.241 ±0. 169, 1.328 ±0.248,1.046 ±0.030,an0.05). Conclusion Most of the patients with asymptomatic severe internal carotid stenosis has cognitive impairment, and cerebral perfusion caused by stenosis is significantly slower in patients with cognitive impairment than in those with noncognitive impairment.


Cai Y.-L.,306 th Hospital of Peoples Liberation Army | Du J.,306 th Hospital of Peoples Liberation Army | Zheng D.,306 th Hospital of Peoples Liberation Army | Cui Y.-Q.,306 th Hospital of Peoples Liberation Army | Wu Q.,306 th Hospital of Peoples Liberation Army
Chinese Journal of Cerebrovascular Diseases | Year: 2011

Objective: To evaluate the of cerebral blood perfusion changes after carotid artery stenting using CT perfusion imaging (CTP). Methods: Thirty-one patients with moderate or severe carotid stenosis were recruited prospectively. They were divided into 3 groups: Asymptomatic group (n = 7), cerebral infarction group (n = 11), and TIA group (n = 13). They were all diagnosed as severe unilateral internal carotid artery stenosis (> 70% stenosis on one side and < 30% stenosis on the other side in the asymptomatic group; ipsilateral stenosis > 50% in the cerebral infarction group and TIA groups). All patients performed carotid artery stenting and a total of 33 stents were implanted. All patients performed CTP examination before stenting and within 7 days after stenting. The relative regional cerebral blood flow (rCBF), relative regional cerebral blood volume (rCBV), relative regional mean transit time (rMTT), and relative regional time to peak (rTTP) before and after stenting in the 3 groups were compared. Results: Circled digit oneComparison before and after stenting in the same group : rTTP (1.01 ± 0.02) accelerated after surgery in the asymptomatic group, and the other perfusion indexes did not change significantly; rTTP (1.10 ± 0.06) and rMTT (1.06 ± 0.04) shortened compared to those before stenting, and rCBF (0.96 ± 0.02) increased in the TIA group; rTTP (1.11 ± 0.05) and rMTT (1.06 ± 0.04) shortened than those before stenting, and rCBF (0.96 ± 0.02) increased in the CI group (all P < 0.05); there were no significant difference in rCBV. Circled digit twoComparison among the 3 groups: there were significant differences in rTTP, rMTT and rCBF before stenting among the 3 groups (all P < 0.05); There were no significant differences in rCBV among the 3 groups. There were significant differences in rTTP among the 3 groups (P < 0.05). There were no significant differences in rMTT, rCBF, and rCBV among the 3 groups. Conclusion: CTP may accurately reflect the hemodynamic status before and after stenting in patients with carotid artery stenosis. It can be used as a noninvasive evaluation method of cerebral hemodynamic changes after carotid artery stenting. rTTP is a very sensitive index for evaluating early ischemia and compensatory capacity of collateral circulation.

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