非时变CTA在急性脑梗死患者脑侧支循环的应用研究  

Time-invariant CTA assessment of collateral circulation of patients with acute ischemic stroke

作　　者：温学花[1] 丁忠祥[1] 李玉梅[1] 袁建华[1] 龚向阳[1] 

机构地区：[1]浙江省人民医院放射科,浙江杭州310014

出　　处：《实用放射学杂志》2017年第3期365-368,共4页Journal of Practical Radiology

摘　　要：目的 探讨非时变CT血管成像（CTA）技术在评估急性脑梗死患者脑侧支循环和辅助临床医生预测患者临床预后方面的价值.方法 评估并比较急性脑梗死患者脑侧支循环在单时相CTA和非时变CTA的评分;计算急性脑梗死患者于入院后2周较入院时的美国国立卫生研究院卒中量表（NIHSS）评分变化,NIHSS评分下降≥50%定义为较大的神经功能改善,代表临床预后良好,否则为临床预后差;基于受试者工作特征（ROC）曲线评估非时变CTA在预测患者临床预后方面的效能.结果 在显示急性脑梗死患者脑侧支循环方面,非时变CTA较单时相CTA能够显示更多的侧支血管,非时变CTA和单时相CTA脑侧支循环评分分别为（1.50±0.69）分和（1.15±0.49）分（P=0.006〈0.05）;非时变CTA对急性脑梗死患者临床预后具有中等度的预测效能,曲线下面积（AUC）=0.810,（P=0.032〈0.05）.结论 非时变CTA在评价急性脑梗死患者脑侧支循环和辅助临床医生预测患者临床预后方面具有重要价值.Objective To explore the value of time-invariant CTA in assessing collateral circulation of patients with acute ischemic stroke and assisting clinicians in predicting clinical outcomes.Methods The score of collateral circulation was compared between single-phase and time-invariant CTA.NIHSS score was calculated at admission and two weeks after admission.A 50% or greater decrease in NIHSS score over two weeks was considered as major neurologic improvement,which showed good clinical outcome;otherwise,it indicated bad outcome.The predictive ability of time-invariant CTA for clinical outcomes was assessed based on ROC curves.Results Compared with single-phase CTA,more collateral vessels could be viewed on time-invariant CTA.The average score of collateral circulation on time-invariant and single-phase CTA was 1.50±0.69 and 1.15±0.49 respectively （P=0.006〈0.05 ）.Time-invariant CTA had the moderate predictive ability for clinical outcomes in patients with acute ischemic stroke （AUC=0.810;P=0.032〈0.05）. Conclusion The time-invariant CTA showed potential value in assessing collateral circulation of patients with acute ischemic stroke and assisting clinicians in predicting clinical outcomes.

关 键 词：脑梗死 灌注成像 血管造影术 侧支循环 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R814.42[医药卫生—临床医学]