Predictive Value of CTP and SWI for Hemorrhagic Transformation in Acute Ischemic Stroke
Objective To explore the predictive value of CT perfusion(CTP)and susceptibility weighted imaging(SWI)for hemorrhagic transformation in acute ischemic stroke.Methods A total of 108 patients with acute ischemic stroke admitted to the hospital were enrolled between January 2021 and December 2023.All underwent CTP and SWI examinations to analyze imaging characteristics.Taking digital subtraction angiography(DSA)as the golden standard,the consistency between CTP,SWI and the golden standard was compared to analyze their diagnostic efficiency.The detection rates of different classifications of hemorrhagic transformation by different examination methods were compared.Results DSA showed that in the 108 patients,there were 37 cases with hemorrhagic transformation,including 17 cases of type HI-1,10 cases of type HI-2,6 cases of type PH-1 and 4 cases of type PH-2.Kappa value between CTP and the golden standard was 0.582,showing general consistency.Kappa value between SWI and the golden standard was 0.609,showing high consistency.Kappa value between combined detection and the golden standard was 0.741,showing high consistency.The sensitivity,specificity and accuracy of CTP,SWI and combined detection for predicting hemorrhagic transformation were(78.38％,81.69％,80.56％),(83.78％,80.28％,81.48％)and(89.19％,85.25％,86.73％),respectively.The detection rate of type HI-1 by combined detection was higher than that by CTP and SWI alone(P＜0.05),but there was no significant difference between CTP and SWI(P＞0.05).There was no significant difference in detection rates of types HI-2,PH-1 and PH-2 among CTP,SWI and combined detection(P＞0.05).Conclusion CTP combined with SWI has high predictive value for hemorrhagic transformation in patients with acute ischemic stroke,which can effectively identify different classifications of hemorrhagic transformation and provide reference for clinical prevention and management of hemorrhagic transformation.
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