CT灌注成像联合CT血管成像对急性脑梗死患者近期神经功能预后的预测效能
The value of CT perfusion imaging combined with CT angiography in predicting short-term neurological prognosis of patients with acute cerebral infarction
杨榕 1周琳 1周海伟 1王一鸣1
作者信息
摘要
目的 探讨CT灌注成像联合CT血管成像对急性脑梗死患者近期神经功能预后的预测效能.方法 回顾性选择2019年12月至2022年4月舟山医院收治的急性脑梗死患者212例,均在入院24h内行CT灌注成像和CT血管成像检查.治疗后随访3个月,根据改良Rankin评分量表(mRS)的评分结果分为预后良好组和预后不良组.比较两组患者CT灌注成像测量值,包括脑血容量(CBV)、脑血流量(CBF)、达峰时间(TTP)、平均通过时间(MTT).比较两组患者CT血管成像指标[Alberta卒中项目早期CT评分(ASPECTS)].绘制ROC曲线分析CT灌注成像联合CT血管成像对急性脑梗死患者近期神经功能预后的预测效能.结果 预后良好组166例,预后不良组46例.预后不良组美国国立卫生研究院卒中量表评分、TTP、MTT高于预后良好组,CBV、CBF、ASPECTS低于预后良好组,差异均有统计学意义(均P＜0.05).CT灌注成像预测急性脑梗死患者近期神经功能预后不良的灵敏度和AUC分别为0.745、0.820,CT灌注成像联合CT血管成像预测急性脑梗死患者近期神经功能预后不良的灵敏度和AUC分别为0.902、0.919,均高于单独预测(均P＜0.05).结论 CT灌注成像联合CT血管成像可提高对急性脑梗死患者近期神经功能预后不良的预测效能.
Abstract
Objective To explore the value of combining CT perfusion imaging with CT angiography in predicting short-term neurological prognosis of patients with acute cerebral infarction(ACI).Methods Clinical data of 212 ACI patients admitted to Zhoushan Hospital from December 2019 to April 2022 were analyzed retrospectively.All patients underwent CT perfusion imaging and CT angiography within 24 h after admission.The patients were followed up for three months after treatment and divided into good prognosis group and poor prognosis group based on Rankin Rating scale(mRS)scores.The CT perfusion imaging measurements such as cerebral blood volume(CBV),cerebral blood flow(CBF),time to peak(TTP),and mean transit time(MTT)and Alberta stroke early CT score(ASPECTS)on CT angiography were compared between the two groups.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of CT perfusion imaging combined with CT angiography for short-term neurological prognosis in ACI patients.Results A total of 166 patients had good prognosis and 46 patients had poor prognosis.The National Institutes of health stroke scale(NIHSS)scores in the poor prognosis groups of TTP and MTT were higher than those in the good prognosis group,while the CBV,CBF and ASPECTS scores in the poor prognosis groups of TTP and MTT were lower than those in the good prognosis group(P＜0.05).CT perfusion imaging was used to predicted neurologic function prognosis in patients with acute cerebral infarction with sensitivity 0.745 and AUC 0.820,while CT perfusion imaging combined with CT angiography as used to predicted neurologic function prognosis in patients with acute cerebral infarction with sensitivity 0.902 and 0.919,respectively.All were higher than individual predictions(both P＜0.05).Conclusion A combination of CT perfusion imaging and CT angiography can improve predictive power for short-term poor neurological prognosis in ACI patients.
关键词
CT灌注成像/CT血管成像/急性脑梗死/神经功能/预测Key words
CT perfusion imaging/CT angiography/Acute cerebral infarction/Neurological function/Prediction引用本文复制引用
出版年
2024
NETL
NSTL
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