摘要
目的 探讨多层CT全脑灌注成像技术在急性脑梗死诊断中的效果.方法 选取 2021 年 1 月至 2022 年 12 月本院收治的 73例高度疑似急性脑梗死患者作为研究对象,所有研究对象均表现出不同程度的脑梗死临床症状,使用双源螺旋CT机对患者进行头颅CT平扫和CT灌注成像,对患者的病情进行诊断,采用磁共振成像(MRI)作为金标准,并将 2 种方法检查诊断结果进行比较;比较多层CT全脑灌注成像技术与MRI对患者梗死部位诊断的结果;比较急性脑梗死患者核心梗死区、梗死周边和健侧镜像区的脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)和达峰所需时间(TTP)等脑灌注参数.结果 MRI结果显示 73例患者有 70 例确诊为急性脑梗死,多层CT全脑灌注成像技术结果显示,73 例患者中有 67 例被确诊为急性脑梗死,3 例漏诊,准确率为 96%,1种方法诊断的Kappa值为 0.647,一致性较高;MRI诊断结果显示,70 例急性脑梗死患者中有 27 例丘脑-基底节区梗死、13 例脑干梗死、18 例单个脑叶梗死,12 例大面积梗死,诊断准确率为 100%.多层CT全脑灌注成像技术诊断结果为 29 例丘脑-基底节区梗死、12 例脑干梗死、15 例单个脑叶梗死,12 例大面积梗死,4 例漏诊,2 例误诊,诊断准确率为 91%,2 种方法诊断的准确率比较差异无统计学意义(χ2=0.34,P＞0.05);多层CT灌注成像技术测定核心梗死区、梗死周边以及健侧镜像区灌注参数显示,核心梗死区、梗死周边和健侧镜像区的CBF、CBV、TTP、MTT差异具有统计学意义(P<0.05).梗死周边的CBF、CBV水平低于健侧镜像区(P<0.05),TTP、MTT水平低于高于健侧镜像区(P<0.05).与梗死周边和健侧镜像区相比,核心梗死区的TTP、MTT水平升高(P<0.05),CBF、CBV水平降低(P<0.05).结论 多层CT全脑灌注成像技术评估诊断急性脑梗死的准确率较高,在临床上具有较高的应用推广价值.
Abstract
Objective To explore the effectiveness of multi-slice CT whole brain perfusion imaging technology in the diagnosis of acute cerebral infarction.Methods From January 2021 to December 2022,73 highly suspected acute cerebral infarction patients accepted by our hospital were collected as the study subjects,all of whom exhibited varying degrees of clinical symptoms of cerebral infarction,the dual source spiral CT machine was applied to patients for head CT plain scan and CT perfusion imaging to diagnose the patients' condition,magnetic resonance imaging(MRI)was used as the gold standard method and the diagnostic results of the two methods were compared.The results of multi-slice CT whole brain perfusion imaging technology and MRI in diagnosing the infarct site of patients were compared.The cerebral perfusion parameters such as cerebral blood volume(CBV),cerebral blood flow(CBF),mean transit time(MTT),and time to peak(TTP)were compared in the core infarct area,periinfarct area,and contralateral mirror area of acute cerebral infarction patients.Results MRI showed that 70 out of 73 patients were diagnosed with acute cerebral infarction,multi-slice CT whole brain perfusion imaging technology showed that 67 out of 73 patients were diagnosed with acute cerebral infarction,and 3 were missed,with an accuracy rate of 96%,the Kappa value of the two methods for diagnosis was 0.647,indicating high consistency.The MRI diagnostic results showed that among 70 patients with acute cerebral infarction,there were 27 cases with thalamic basal ganglia infarction,13 cases with brainstem infarction,18 cases with single lobe infarction,and 12 cases with large area infarction,with a diagnostic accuracy of 100%.The diagnostic results of multi-slice CT whole brain perfusion imaging technology were 29 cases with thalamic basal ganglia infarction,12 cases with brainstem infarction,15 cases of single lobe infarction,12 cases withlarge area infarction,4 cases with missed diagnosis,2 cases with misdiagnosis,the diagnostic accuracy rate was 91%,and the difference in diagnostic accuracy between the two methods was not statistically obvious(χ2=0.40,P＞0.05).The results of multi-slice CT perfusion imaging technology in detecting the perfusion parameters of the core in-farct area,infarct periphery,and contralateral mirror area showed there were statistical differences in CBF,CBV,TTP,and MTT among the core infarct area,infarct periphery,and contralateral mirror area(P<0.05).The levels of CBF and CBV around the infarct were lower than those in the healthy mirror area(P<0.05),while the levels of TTP and MTT were higher than those in the healthy mirror area(P<0.05).Compared with the surrounding infarct area and the healthy mirror area,the levels of TTP and MTT in the core infarct area were increased(P<0.05),while the levels of CBF and CBV were reduced(P<0.05).Conclusion Multi-slice CT whole brain perfusion imaging technology has a high accuracy in evaluating and diagnosing acute cerebral infarction,and has high clinical application and promotion value.
NETL
NSTL
维普
万方数据