Objective: To study the clinical value of multi-slice spiral CT (MSCT) perfusion technique in evaluation of cerebral hemodynamics in patients with severe carotid stenooclusive lesions.
Methods: Twenty-three patients with severe carotid stenosis were enrolled for evaluation of cerebral hemodynamics, including 12 patients with carotid occlusion and 11 with severe carotid stenosis (> 70%). Among them, 16 patients had multiple arterial diseases, including contralateral carotid stenosis, vertebral arteries stenosis, and cerebral arteries stenosis or occlusion. All patients received CT perfusion examination. Ten normal persons received CT perfusion were regarded as the control group.
Results: Cerebral perfusion was bilaterally symmetrical in 10 normal persons. While in the patients group, cerebral hemodynamic impairments ipsilateral to the stenosis side were found by CT perfusion in 17 patients, including an delay of time to peak (TTP) (17 patients), increase of cerebral blood volume (CBV) (7 patients), and decrease of cerebral blood flow (CBF) (4 patients). No significant difference was found between occlusion group (n = 8) and stenosis group (n = 9) (P = 0.640), but incidences of hemodynamic impairment were significantly higher in multiple arterial diseases group (n = 14) than single arterial disease group (n = 3) (P = 0.045).
Conclusion: CT perfusion technique can sensitively reveal the cerebral hemodynamic impairments in patients with severe carotid stenooclusive diseases, and therefore valuable for clinical application.