摘要
目的探讨CT灌注成像(CTPI)参数对急性脑梗死(ACI)侧支循环的评估价值及与术后近期预后的相关性。方法选取我院2022年1月-2023年2月收治的106例ACI患者,以数字血管造影(DSA)作为诊断“金标准”,将其分有侧支循环组(46例)与无侧支循环组(60例)。两组患者均进行CTPI检查,对比两组受试者CTPI参数[脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)及达峰时间(TTP)],采用受试者工作特征(ROC)曲线分析CTPI参数对ACI侧支循环的预测价值;比较CTPI参数评估急性缺血性脑梗死侧支循环与DSA检查的一致性;采用Pearson相关性分析ACI患者的CTPI参数与美国国立卫生研究院卒中量表(NIHSS)、改良Ranking量表(mRS)评分的相关性。结果有侧支循环组CBV、CBF均高于无侧支循环组(P<0.05),MTT、TTP均低于无侧支循环组(P<0.05)。ROC曲线分析显示,CBV、CBF、MTT、TTP及联合检测对ACI侧支循环均有预测效能(P<0.05),其AUC分别为0.793、0.705、0.841、0.669、0.879,单独检测中MTT效能最高,但仍低于联合检测效能。CTPI参数联合检查对ACI侧支循环的诊断灵敏性为84.78%、特异性为90.00%、准确率为87.74%、阳性预测值为86.67%、阴性预测值为88.52%、Kappa值为0.750。有侧支循环组NIHSS、mRS评分均低于无侧支循环组(P<0.05);Pearson相关分析发现,CBV、CBF与NIHSS、mRS评分呈负相关(P<0.05),MTT、TTP与NIHSS、mRS评分呈正相关(P<0.05)。结论ACI有侧支循环患者的CBV、CBF均较无侧支循环患者高,MTT、TTP均较无侧支循环患者低,CTPI参数用于评估ACI侧支循环具有较高的诊断效能,且有侧支循环患者近期预后较好,同时CBV、CBF、MTT、TTP与ACI患者近期预后均存在相关性,可通过检测CBV、CBF、MTT、TTP预测患者近期预后。
Objective To explore the evaluated value of CT perfusion imaging(CTPI)parameters on collateral circulation of acute cerebral infarction(ACI)and its correlation with postoperative short-term prognosis.Methods 106 patients with ACI admitted to the hospital from January 2022 to February 2023 were selected.Digital subtraction angiography(DSA)was used as the"gold standard"for diagnosis,and the patients were divided into collateral circulation group(46 cases)and non-collateral circulation group(60 cases).CTPI examination was performed in both groups.CTPI parameters[cerebral blood volume(CBV),cerebral blood flow(CBF),mean transit time(MTT),time to peak(TTP)]were compared between the two groups of subjects,and the predictive value of CTPI parameters on ACI collateral circulation was analyzed by receiver operating characteristic(ROC)curve.The consistency of CTPI parameters in evaluating collateral circulation of acute ischemic cerebral infarction with DSA examination was compared.Pearson correlation analysis was used to analyze the correlation between CTPI parameters of patients with ACI and scores of National Institutes of Health Stroke Scale(NIHSS)and Modified Ranking Scale(mRS).Results The CBV and CBF in collateral circulation group were higher than those in non-collateral circulation group(P<0.05),and the MTT and TTP were shorter than those in non-collateral circulation group(P<0.05).ROC curve analysis showed that the CBV,CBF,MTT,TTP and combined detection had predictive efficiency on ACI collateral circulation(P<0.05),and their AUCs were 0.793,0.705,0.841,0.669 and 0.879 respectively.MTT had the highest efficiency in single detection,but it was still lower than combined detection.The sensitivity,specificity,accuracy rate,positive predictive value,negative predictive value and Kappa value of the combination of CTPI parameters in the diagnosis of ACI collateral circulation were 84.78%,90.00%,87.74%,86.67%,88.52%and 0.750 respectively.NIHSS score and mRS score were lower in collateral circulation group than those in non-collateral circulation group(P<0.05).Pearson correlation analysis found that CBV and CBF were negatively correlated with NIHSS score and mRS score(P<0.05),but MTT and TTP were positively correlated with NIHSS score and mRS score(P<0.05).Conclusion The CBV and CBF of ACI patients with collateral circulation are higher than those of patients without collateral circulation,and the MTT and TTP are shorter than those of patients without collateral circulation.CTPI parameters have high diagnostic efficiency on evaluating the collateral circulation of ACI,and the short-term prognosis of patients with collateral circulation is better.CBV,CBF,MTT and TTP are correlated with short-term prognosis of ACI patients.The short-term prognosis of patients can be predicted by detecting CBV,CBF,MTT and TTP.
作者
时建文
杨忠泽
刘森
SHI Jian-wen;YANG Zhong-ze;LIU Sen(CT and MRI Room,Jixi People's Hospital,Jixi 158100,Heilongjiang Province,China;Medical Imaging Department,Jixi People's Hospital,Jixi 158100,Heilongjiang Province,China)
出处
《中国CT和MRI杂志》
2024年第2期42-44,共3页
Chinese Journal of CT and MRI
基金
鸡西市科学技术计划项(41408654-5)。
关键词
CT灌注成像
急性脑梗死
侧支循环
评估价值
近期预后
相关性
CT Perfusion Imaging
Acute Cerebral Infarction
Collateral Circulation
Evaluated Value
Short-term Prognosis
Correlation
