摘要
目的:探究CT灌注联合MRI在急性脑梗缺血半暗带评估中的价值。方法:回顾性分析本院2020年1月—2022年1月收治的152例急性脑梗死患者的全脑CT灌注、MRI检查结果;分析其对急性脑梗缺血半暗带的评估价值。结果:急性脑梗死患者核心梗死区脑血容量(CBV)、脑血流量(CBF)较健侧对应区降低,平均通过时间(MTT)、达峰时间(TTP)较健侧对应区升高(P<0.05);缺血半暗带区与健侧对应区CBV差异不显著,CBF水平较健侧对应区降低,MTT、TTP水平较健侧对应区升高(P<0.05);缺血半暗带区CBV、CBF水平显著高于梗死核心区,MTT、TTP水平低于梗死核心区(P<0.05);急性脑梗死患者缺血半暗带与健侧对应区表观弥散系数(ADC)值比较差异无统计学意义(P>0.05),梗死核心区与健侧对应区ADC值比较差异有统计学意义(P<0.05),但缺血半暗带区rADC值显著高于梗死核心区(P<0.05);CT灌注参数中诊断鉴别缺血半暗带最高AUC值、敏感度、特异度分别为0.992、97.37%、96.71%;MRI参数中鉴别诊断缺血半暗带的最高AUC值、敏感度、特异度分别为0.688、73.68%、56.58%;CT灌注参数联合MRI评估急性脑梗死缺血半暗带的AUC为0.999(0.986~1.000),约登指数0.980,临界值为0.238,敏感度、特异度分别为100.00%、98.03%。结论:采用CT灌注联合MRI评估急性脑梗死缺血半暗带效果良好,具有较好的敏感度与特异度,值得临床推广。
Objective:To investigate the value of CT perfusion combined with MRI in evaluating the ischemic penumbra of acute cerebral infarction.Methods:The whole brain CT perfusion and MRI examination results of 152 patients with acute cerebral infarction who were admitted to the hospital from January 2020 to January 2022 were analyzed retrospectively.The value of CT perfusion and MRI in evaluating the ischemic penumbra of acute cerebral infarction was analyzed.Results:Cerebral blood volume(CBV)and cerebral blood flow(CBF)in the core infarction area were lower than those in corresponding area on the healthy side,while the mean transit time(MTT)and time to peak(TTP)were longer than those in corresponding area on the healthy side(P<0.05).CBV in the ischemic penumbra and corresponding area on the healthy side was similar.CBF in the ischemic penumbra was lower than that in corresponding area on the healthy side,while MTT and TTP were longer than those in corresponding area on the healthy side(P<0.05).CBV and CBF in the ischemic penumbra were significantly higher than those in the core infarction area,while MTT and TTP were shorter than those in the core infarction area(P<0.05).There was no statistically significant difference in the apparent diffusion coefficient(ADC)value between the ischemic penumbra and corresponding area on the healthy side(P>0.05).There was a statistically significant difference in ADC value between the core infarction area and corresponding area on the healthy side(P<0.05).The rADC value of the ischemic penumbra was significantly higher than that of the core infarction area(P<0.05).Among CT perfusion parameters,the highest AUC,sensitivity and specificity for diagnosing and distinguishing ischemic penumbra were 0.992,97.37%and 96.71%,respectively.Among MRI parameters,the highest AUC,sensitivity and specificity for diagnosing and distinguishing ischemic penumbra were 0.688%,73.68%and 56.58%,respectively.The AUC of CT perfusion parameters combined with MRI for evaluating the ischemic penumbra of acute cerebral infarction was 0.999(0.986~1.000),and Youden index was 0.980.When the critical value was 0.238,the sensitivity and specificity were 100.00%and 98.03%.Conclusion:The combination of CT perfusion and MRI is effective in evaluating the ischemic penumbra of acute cerebral infarction,with good sensitivity and specificity,and is worthy of clinical promotion.
作者
甘荣坤
李亮
陈思敏
林怀雄
刘昌华
GAN Rong-kun;LI Liang;CHEN Si-min;LIN Huai-xiong;LIU Chang-hua(Imaging Department,the 73rd Group Military Hospital of the People’s Liberation Army,Xiamen Fujian 361000,China)
出处
《中国临床医学影像杂志》
CAS
CSCD
北大核心
2024年第5期316-320,共5页
Journal of China Clinic Medical Imaging
关键词
脑梗死
磁共振成像
体层摄影术
螺旋计算机
Brain Infarction
Magnetic Resonance Imaging
Tomography,Spiral Computed
