目的 分析CT血管造影(CTA)对 脑梗死伴颈动脉狭窄患者脑血流动力学 改变的评价作用。方法 收集2012年3 月-2015年10月我院收治的50例脑梗死伴 颈动脉狭窄患者的临床资料，所有患者 均经经颅多普勒超声(TCD)提示存在不 同程度狭窄或闭塞表现，入院后均完成 CTA、CT灌注扫描(CTP)检查，分析CTA对 患者脑血流动力学改变的评估价值。结 果 对照组、轻度狭窄、中度狭窄患者额 叶、颞叶、基底节区脑血流动力学参数 对比差异无统计学意义(P＞0.05)；重度 狭窄、完全闭塞组患者额叶、颞叶、基 底节区CBF低于对照组，CBV、MTT、TTP 均高于对照组(P＜0.05)；CTA检出正常 43支，轻度狭窄9支，中度狭窄12支，重 度狭窄23支，闭塞13支，与TCD结果一致 性较高(P＜0.05)。结论 CTA配合CTP检 查有助于综合评估脑梗死伴颈动脉狭窄 患者脑血流动力学改变情况，可为临床 治疗提供影像学指导。

Objective To analyze the effect of CT angiography (CTA) in evaluation of cerebral hemodynamic changes in patients with cerebral infarction complicated with carotid stenosis. Methods The clinical data of 50 patients with cerebral infarction and carotid stenosis admitted in our hospital between March 2012 and October 2015 were collected. All patients were examined by transcranial Doppler ultrasound (TCD), indicating there were different degrees of stenosis or occlusion. CTA and CT perfusion scan (CTP) were performed after admission. The value of CTA in evaluating the cerebral hemodynamic changes in patients was analyzed. Results There were no significant differences in the hemodynamic parameters of frontal lobe, temporal lobe and basal ganglia between patients in control group, patients with mild stenosis and patients with moderate stenosis (P＞0.05). CBF of frontal lobe, temporal lobe and basal ganglia in patients with severe stenosis or total occlusion were lower than those in control group while CBV, MTT and, TTP and CBF were higher than those in control group (P＜0.05); CTA showed 43 normal branches, 9 branches with mild stenosis, 12 branches with moderate stenosis, 23 branches with severe stenosis, and 13 branches with occlusion. The consistency with the results of TCD was high (P＜0.05). Conclusion CTA combined with CTP examination is helpful to the comprehensive evaluation of cerebral hemodynamic changes in patients with cerebral infarction complicated with carotid stenosis, which can provide imaging guidance for clinical treatment.