摘要
目的探讨CT血管成像(CTA)/CT灌注成像(CTP)在缺血性脑血管病介入治疗中的应用价值。方法选取2021年1月至2023年9月我院收治的200例缺血性脑血管病患者,均在入院后接受CTA及CTP检查,分析其影像资料,探究CTA及CTP缺血性脑血管病介入治疗中的应用价值。结果脑血容量(CBV)比较:缺血半暗带>健侧>梗死区(P<0.05);脑血流量(CBF)比较:健侧>缺血半暗带>梗死区(P<0.05);平均通过时间(MTT)、目标组织中浓度达峰时间(TTP)、目标组织中所有残余功能全部达峰时间(Tmax)比较:健侧<缺血半暗带<梗死区(P<0.05)。CTA检出左侧、右侧大脑中动脉(MCA)闭塞或狭窄分别59例(29.50%)、91例(45.50%),左侧、右侧颈内动脉(ICA)闭塞分别16例(8.00%)、12例(6.00%),双侧ICA狭窄为6例(3.00%);代偿分支血管显影基本满意129例(64.50%),显影不足71例(35.50),其余16例(8.00%)患者CTA影像资料显示无异常,敏感度为92.00%。预后不良组患侧CBV、CBF小于预后良好组,MTT、TTP、Tmax长于预后良好组,代偿血管建立比例低于预后良好组(P<0.05)。采用受试者工作特征曲线分析显示,CBV、CBF、MTT、TTP、Tmax对介入治疗预后均有一定的预测效能(P<0.05),其曲线下面积分别为0.839、0.815、0.673、0.713、0.710,其中CBV预测效能最高,敏感性为83.20%,特异性为73.33%。结论CTA/CTP可反映大脑、颈内动脉狭窄或闭塞、代偿分支建立情况,也可反映血流灌注情况,在介入治疗合理时机的判断方面可提供准确依据,提高患者预后。
Objective To explore the application value of CT angiography(CTA)/CT perfusion(CTP)in interventional therapy of ischemic cerebrovascular diseases.Methods 200 patients with ischemic cerebrovascular diseases in our hospital were selected from January 2021 to September 2023.All patients underwent CTA examination and CTP examination after admission.The imaging data were analyzed to explore the application value of CTA and CTP in interventional therapy of ischemic cerebrovascular diseases.Results Comparison of cerebral blood volume(CBV)revealed ischemic penumbra>healthy side>infarction area(P<0.05).Cerebral blood flow(CBF)was as follows:healthy side>ischemic penumbra>infarction area(P<0.05).Mean transit time(MTT),time to peak(TTP)and time to maximum(Tmax)showed healthy side<ischemic penumbra<infarction area(P<0.05).CTA detected left and right middle cerebral artery(MCA)occlusion or stenosis in 59 cases(29.50%)and 91 cases(45.50%),left and right internal carotid artery(ICA)occlusion in 16 cases(8.00%)and 12 cases(6.00%),and bilateral ICA stenosis in 6 cases(3.00%).The development of compensatory branch vessels was basically satisfactory in 129 cases(64.50%)and insufficient in 71 cases(35.50%),and the CTA imaging data of the remaining 16 cases(8.00%)showed no abnormality,with a sensitivity of 92.00%.The CBV and CBF of the affected side in poor prognosis group were lower than those in good prognosis group,and the MTT,TTP and Tmax were longer than those in good prognosis group,and the proportion of compensatory vascular establishment was lower than that in good prognosis group(P<0.05).Receiver operating characteristic curve analysis showed that CBV,CBF,MTT,TTP and Tmax had certain predictive efficiency on the prognosis of interventional therapy(P<0.05),and the areas under the curves were 0.839,0.815,0.673,0.713 and 0.710 respectively.CBV had the highest predictive efficiency,with a sensitivity of 83.20%and a specificity of 73.33%.Conclusion CTA/CTP can reflect the stenosis or occlusion of the brain and internal carotid artery,the establishment of compensatory branches,and the blood perfusion.It can provide an accurate basis for judging the reasonable timing of interventional therapy and improve the prognosis of patients.
作者
周新华
陈良义
张丹彤
ZHOU Xin-hua;CHEN Liang-yi;ZHANG Dan-tong(Imaging Department of Zhongshan Hospital Affiliated to Xiamen University,Xiamen 3610000,Fujian Province,China;Department of Neurology,Zhongshan Hospital Affiliated to Xiamen University,Xiamen 3610000,Fujian Province,China)
出处
《中国CT和MRI杂志》
2024年第4期20-22,共3页
Chinese Journal of CT and MRI
关键词
CT血管成像
CT灌注成像
缺血性脑血管病
介入治疗
指导
预后
CT Angiography
CT Perfusion Imaging
Ischemic Cerebrovascular Diseases
Interventional Therapy
Guidance
Prognosis
