Correlation of CT Perfusion Parameters with Middle Cerebral Artery Stenosis Degree and Prognosis
Objective To explore the correlation of CT perfusion(CTP)parameters with middle cerebral artery(MCA)stenosis degree and prognosis.Methods 105 patients with MCA stenosis in the hospital were selected from January 2022 to December 2023,and were divided into mild stenosis group(n=27),moderate stenosis group(n=46)and severe or total occlusion group(n=32)according to the degree of stenosis.All three groups of patients underwent CTP examination after admission.The CTP parameters[cerebral blood volume(CBV),cerebral blood flow(CBF),mean transit time(MTT),time to peak(TTP)]were compared among the three groups.The patients were followed up for 3 months,and the prognosis of patients was assessed.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of CTP parameters on the prognosis in patients with MCA stenosis.Results DSA examination showed mild stenosis in 27 cases(25.71％),moderate stenosis in 46 cases(43.81％),and severe or total occlusion in 32 cases(30.48％).With DSA as the gold standard,the Kappa values of CTP in evaluating mild stenosis,moderate stenosis and severe or total occlusion were 0.871,0.866 and 0.908 respectively,and the consistency with DSA was strong.The CBV and CBF of the affected side in the three groups were lower than those of the healthy side(P＜0.05),and MTT and TTP were longer than those of the healthy side(P＜0.05).The CBV and CBF in severe or total occlusion group were lower than those in moderate stenosis group and mild stenosis group(P＜0.05),and the indicators in moderate stenosis group were lower than those in mild stenosis group(P＜0.05).The TTP in severe or total occlusion group was longer than that in moderate stenosis group and mild stenosis group(P＜0.05),and the TTP was longer in moderate stenosis group than that in mild stenosis group(P＜0.05).The MTT in severe or total occlusion group was longer than that in moderate stenosis group and mild stenosis group(P＜0.05),and the MTT of the healthy side in moderate stenosis group was higher compared to mild stenosis group(P＜0.05),but there was no statistical difference in MTT of the affected side between moderate stenosis group and mild stenosis group(P＞0.05).CBV and CBF in good prognosis group were higher(P＜0.05),and MTT and TTP were shorter than those in poor prognosis group(P＜0.05).ROC curve analysis showed that the combined detection of CBV,CBF,MTT,TTP and CTP parameters had predictive efficiency on the prognosis in patients with MCA stenosis(P＜0.05),and the areas under the curves(AUCs)were 0.737,0.741,0.664,0.774 and 0.981 respectively.The TTP efficiency was the highest,but it was still lower than that of combined detection.Conclusion CBV and CBF are decreased and MTT and TTP are lengthened in patients with MCA stenosis.The combination of CTP parameters has high efficiency on evaluating the prognosis inn patients with MCA stenosis.
万方数据
维普
