Value analysis of cranial CT angiography for diagnosis and prognosis of patients with acute ischemic stroke
Objective To explore the clinical value of cranial CT angiography for diagnosis and prognosis of patients with acute ischemic stroke.Methods The clinical data of 66 patients with acute ischemic stroke were retrospectively analyzed,and the patients underwent cranial CT plain scan and cranial CT angiography within 24 h after onset.Using the results of digital subtraction angiography as the gold standard,the detection rate and missed diagnosis rate of cranial CT plain scan and cranial CT angiography for acute ischemic stroke were compared,and the diagnostic efficiency of cranial CT angiography for cerebrovascular stenosis/occlusion and cerebrovascular collateral circulation in patients with acute ischemic stroke was analyzed.According to the modified Rankin scale score at 90 d after discharge,the patients were divided into the poor prognosis group and the good prognosis group,and the results of cerebrovascular stenosis/occlusion and cerebrovascular collateral circulation by cranial CT angiography were compared between the poor prognosis group and the good prognosis group.Results The detection rate of cranial CT angiography for acute ischemic stroke was 93.94%(62/66),which was significantly higher than 78.79%(52/66)of cranial CT plain scan,and the difference was statistically significant(χ2=6.433,P<0.05).Digital subtraction angiography showed that 7 of the 66 patients had no cerebrovascular stenosis and 59 cases had cerebrovascular stenosis/occlusion.Cranial CT angiography showed that 8 of the 66 patients had no cerebrovascular stenosis and 58 cases had cerebrovascular stenosis/occlusion.Using digital subtraction angiography as the gold standard,the compliance of cranial CT angiography for cerebrovascular stenosis/occlusion in patients with acute ischemic stroke was 93.94%(62/66).Digital subtraction angiography showed that 30 of 66 patients had good collateral circulation and 36 cases had poor collateral circulation.Cranial CT angiography showed that 29 of the 66 patients had good collateral circulation and 37 cases had poor collateral circulation.Using digital subtraction angiography examination as the gold standard,the sensitivity of cranial CT angiography for poor cerebrovascular collateral circulation in patients with acute ischemic stroke was 88.89%(32/36),the specificity was 83.33%(25/30),and the accuracy was 86.36%(57/66).Patients were categorized into a poor prognosis group(26 patients)and a good prognosis group(40 patients)based on their modified Rankin Scale scores at 90 d after discharge.There were significant differences in cerebrovascular stenosis/occlusion and cerebrovascular collateral circulation between the good prognosis group and the poor prognosis group(P<0.05).Conclusion Cranial CT angiography has high diagnostic efficacy in the diagnosis of acute ischemic stroke,and is able to better diagnose cerebrovascular stenosis/occlusion,cerebrovascular collateral circulation,and also is of great clinical value in the evaluation of patients'prognosis.
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