目的 探究64层CT脑灌注成像 (CTP)在颈内动脉狭窄支架植入治疗(CAS) 疗效中的应用价值。方法 回顾性分析 2016年11月-2018年4月200例单侧颈内动 脉狭窄并于我院行CAS治疗患者术前及术 后的CTP灌注图像(分别在CAS术前1d及术 后5d行64层CTP检查)，取半卵圆中心层面 白质区前、中、后3点为参考，测量双侧 颈内动脉供血区对应部位白质的脑血流 量(CBF)、脑血容量(CBV)、平均通过时 间(MTT)，然后根据患侧值比对侧对应部 位值计算相对值rCBF、rCBV、rMTT。结 果 CAS术前患侧CBV与对侧比较，差异无 统计学意义(P>0.05)；CAS术前患侧CBF较 对侧显著降低，MTT显著延长，差异有统 计学意义(P<0.05)；CAS术后rCBF显著增 加，rMTT显著缩短，差异有统计学意义 (P<0.05)。结论 CTP可较为敏感的反映颈 内动脉狭窄患者脑血流灌注情况，是评价 CAS治疗疗效的可靠方法。

Objective To explore the application value of treatment efficacy of 64-slice CT perfusion imaging (CTP) in the carotid angioplasty and stenting (CAS). Methods The preoperative and postoperative CTP perfusion images (64-slice CTP was given at 1d before CAS and at 5d after operation) of 200 patients with unilateral internal carotid artery stenosis who were given CAS treatment in our hospital from November 2016 to April 2018 were analyzed retrospectively. The front, middle and back points of the white matter area of centrum semiovale were taken as reference, and the cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) measured in the white matter of corresponding parts of bilateral internal carotid artery blood supply area. The relative values rCBF, rCBV and rMTT were calculated based on the contralateral value in corresponding parts. Results There was no significant difference in the CBV between affected side and contralateral side before CAS (P>0.05). The CBF of affected side was significantly lower than that of contralateral side before CAS, and the MTT was significantly prolonged (P<0.05). rCBF increased significantly after CAS while rMTT was significantly shortened (P<0.05). Conclusion CTP can reflect the cerebral perfusion in patients with internal carotid artery stenosis sensitively, and is a reliable method to evaluate the treatment efficacy of CAS.