全脑CT灌注及动态CT血管成像对大脑中动脉狭窄患者预后的预测价值  

Prognostic Value of Whole Brain CT Perfusion and Dynamic CT Angiography in Patients with Middle Cerebral Artery Stenosis

作　　者：赵丽娜[1] 翟江玉 雷明 陆青卫 曹卫强 成学静 赵净 ZHAO Li-na;ZHAI Jiang-yu;LEI Ming;LU Qing-wei;CAO Wei-qiang;CHENG Xue-jing;ZHAO Jing(Department of Imaging,People's Hospital of Dingzhou,Dingzhou,Hebei 073100,China;Department of Nursing,People's Hospital of Dingzhou,Dingzhou,Hebei 073100,China)

机构地区：[1]定州市人民医院影像科,河北定州073100 [2]定州市人民医院护理部,河北定州073100

出　　处：《解放军医药杂志》2020年第9期66-71,共6页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：河北省医学科学研究重点课题计划项目(20191744)。

摘　　要：目的研究全脑CT灌注(CTP)及动态CT血管成像(CTA)对大脑中动脉(MCA)狭窄患者预后的预测价值。方法纳入2018年5月—2019年5月收治的100例MCA狭窄患者作为研究对象,所有患者均接受CTP及动态CTA检查。随访记录患者3个月内脑血管事件发生率,比较不同狭窄程度患者患侧与健侧的CTP参数,包括脑血容量(CBV)、达峰时间(TTP)、平均通过时间(MTT)及延迟时间(DLY)。分析CTP参数判断MCA狭窄患者预后的价值。结果100例MCA狭窄患者中完全闭塞38例、重度狭窄42例、中度狭窄20例,随访3月共发生脑血管事件16例。不同狭窄程度患者患侧CBV、TTP、MTT及DLY水平与健侧比较差异有统计学意义(P<0.05)。不同预后患者健侧CBV、TTP、MTT及DLY比较差异有统计学意义(P<0.05,P<0.01)。受试者工作特征曲线分析显示,健侧CBV、TTP、MTT及DLY对判断MCA狭窄预后有较高应用价值,联合检测上述指标判断预后的特异度为0.815。结论CTP联合CTA检查可评估MCA狭窄患者血管狭窄严重程度,有助于预测患者预后。Objective To investigate the prognostic value of whole brain CT perfusion(CTP)and dynamic CT angiography(CTA)in the prognosis of patients with middle cerebral artery(MCA)stenosis.Methods A total of 100 patients with MCA stenosis treated from May 2018 to May 2019 were included as the research subjects,and all patients underwent CTP and dynamic CTA examination.The incidence of cerebrovascular events were recorded in 100 patients within 3 months by follow-up,and the CTP parameters including cerebral blood volume(CBV),time to peak(TTP),mean transit time(MTT)and delay time(DLY)were compared between the affected side and the healthy side of patients with different degrees of stenosis.The prognostic value of CTP parameters in patients with MCA stenosis was analyzed.Results Among the 100 patients with MCA stenosis,38 patients had complete occlusion,42 patients had severe stenosis and 20 patients had moderate stenosis.A total of 16 patients had cerebrovascular events during 3 months of follow-up.The levels of CBV,TTP,MTT and DLY on the affected side of patients with different degrees of stenosis were significantly different from those on the healthy side(P<0.05).There were significant differences in CBV,TTP,MTT and DLY on the healthy side of patients with different prognosis(P<0.05,P<0.01).Receiver operating curve analysis showed that the CBV,TTP,MTT and DLY on the healthy side had higher application value in evaluating the prognosis of MCA stenosis,and the specificity of combined detection of the above indicators in evaluating the prognosis was 0.815.Conclusion The CTP combined with CTA can evaluate the severity of stenosis in patients with MCA stenosis and is conductive to predicting the prognosis.

关 键 词：CT灌注 动态CT血管成像 大脑中动脉狭窄 预后 ROC曲线 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R816.1[医药卫生—临床医学]