摘要
目的 探讨光谱CT定量参数在超急性期预测大面积脑梗死患者恶性脑水肿(MCE)发生的价值。方法 选取35例在威海市中心医院接受光谱CT检查的超急性期大面积脑梗死患者作为观察对象,根据患者是否发生MCE,将患者分为脑水肿恶性组和非恶性组。计算两组患者脑缺血区净水摄取率(NWU)、碘浓度变化率(ΔIC)及有效原子序数变化率(ΔZ_(eff))。比较各定量参数组间差异,将差异有统计学意义的参数纳入多因素logistic回归,构建logistic回归模型;采用受试者操作特征(ROC)曲线评估各定量参数及回归模型的预测效能。结果 NWU、ΔIC及ΔZ_(eff)组间差异有统计学意义(P<0.05),ΔIC是发生MCE的独立预测因素。由NWU、ΔIC及ΔZ_(eff)建立的回归模型曲线下面积(AUC)为0.889,特异度为88.24%。结论 光谱CT定量参数ΔIC、ΔZ_(eff)与传统CT定量参数NWU建立的回归模型,对预测MCE具有较高的准确率。
Objective To explore the value of quantitative spectral CT in predicting the occurrence of malignant brain edema in patients with hyperacute phase large hemispheric infarction.Methods Thirty-five patients with large hemispheric infarction in the hyperacute stage who underwent spectral CT examination in Weihai Central Hospital were selected as observation subjects.The endpoint of this study was the occurrence of malignant cerebral edema,according to which the patients were divided into a malignant and non-malignant group of cerebral edema.The rates of net water uptake(NWU),iodine concentrations variation rate(ΔIC),and effective atomic number variation rate(ΔZ_(eff))were calculated for the ischemic regions of the brain in both groups of patients.Comparing the differences between groups for each quantitative parameter,parameters with statistically significant differences were included in multifactor logistic regression and logistic regression models were constructed.The predictive efficacy of each quantitative parameter and regression model was assessed using subject operating characteristic(ROC)curves.Results The differences between NWU,ΔIC and ΔZ_(eff) groups were statistically significant(P<0.05),and all of them were positively correlated with malignant cerebral edema,and ΔIC was an independent predictor of the occurrence of malignant cerebral edema.The area under the curve(AUC)of the regression model established by NWU,ΔIC and ΔZ_(eff) was 0.889,with a specificity of 88.24%.Conclusion The regression model established by the spectral CT quantitative parametersΔIC and ΔZ_(eff) and the conventional CT quantitative parameter NWU has high accuracy in the prediction of malignant brain edema.
作者
王英凯
侯红军
崔林阳
于永泉
陈亚楠
WANG Yingkai;HOU Hongjun;CUI Linyang;YU Yongquan;CHEN Yanan(School of Medical Imaging,Weifang Medical University,Weifang 261053,China;Department of Radiology,Weihai Central Hospital,Weihai 264400,China)
出处
《医学影像学杂志》
2024年第2期14-17,共4页
Journal of Medical Imaging
关键词
大面积脑梗死
体层摄影术
X线计算机
光谱成像
恶性脑水肿
Large hemispheric infarction
Tomography,Xray computed
Spectral imaging
Malignant brain edema
