颅脑CT灌注联合头颈CT血管造影成像对早期急性缺血性脑卒中患者的临床应用价值  

Clinical application value of brain CTP combined with head-neck CTA in patients with early acute ischemic stroke

作　　者：刘松国[1] 张涛 孟祥福[1] 韩召春[1] 韩广[1] 于秀英[1] 张昕[1] 刘晓朋 Liu Songguo;Zhang Tao;Meng Xiangfu;Han Zhaochun;Han Guang;Yu Xiuying;Zhang Xin;Liu Xiaopeng(Department of Imaging,Chinese Medicine Hospital in Linyi,Shandong 276000,China;不详)

机构地区：[1]山东省临沂市中医医院医学影像科,276000 [2]山东省临沂市肿瘤医院超声医学科

出　　处：《实用医学影像杂志》2022年第4期335-337,共3页Journal of Practical Medical Imaging

基　　金：临沂市科技发展计划项目(202020049)。

摘　　要：目的 探讨颅脑CT灌注(CTP)联合头颈CT血管造影(CTA)成像对早期急性缺血性脑卒中(AIS)患者的临床应用价值。方法 回顾性分析40例疑似AIS患者资料,观察颅脑CTP参数及头颈CTA责任血管狭窄情况。比较分析临床症状相符的异常灌注区及对侧镜像区脑血容量(CBV)、脑血流量(CBF)及平均通过时间(MTT)等参数,对比颅脑CTP及头颈CTA 2种成像检查阳性检出率,并计算颅脑CTP联合头颈CTA成像诊断早期AIS的灵敏度、特异度、阳性预测值及阴性预测值。结果 40例疑似AIS患者经临床综合诊断及随访结果确诊早期AIS有34例,颅脑CTP成像中临床症状相符的异常灌注区32例,灌注异常区与对侧镜像区的CBV、CBF、MTT差异有统计学意义(P<0.05),颅脑CTP和头颈CTA成像检查阳性检出率分别为80%、50%,二者差异有统计学意义(χ~2=6.76,P=0.009),以临床综合诊断及随访结果为标准,颅脑CTP联合头颈CTA成像的灵敏度94%,特异度83%,阳性预测值97%,阴性预测值71%。结论 颅脑CTP联合头颈CTA检查对早期AIS的评估有较高的价值,能为临床上及时治疗提供依据。Objective To investigate the clinical value of brain CT perfusion(CTP)combined with head-neck CT angiography(CTA)in patients with early acute ischemic stroke(AIS).Methods The data of 40 patients with suspected AIS were retrospectively analyzed.The parameters of brain CTP and the stenosis of responsible vessels of head-neck CTA were observed.CBV,CBF and MTT parameters of abnormal perfusion area and contralateral mirror area were compared and analyzed.The positive detection rates of brain CTP and head-neck CTA were compared.The sensitivity,specificity,positive predictive value and negative predictive value of brain CTP combined with head-neck CTA imaging in the diagnosis of early AIS were calculated.Results Thirty-four cases were diagnosed as early AIS by clinical comprehensive diagnosis and follow-up results among 40 suspected AIS patients.32 cases′abnormal perfusion area were consistent with clinical symptoms in brain CTP imaging.There were significant differences in CBV,CBF and MTT between abnormal perfusion area and contralateral mirror area(P<0.05).The positive detection rates of brain CTP and head-neck CTA imaging were 80%and 50%respectively,the difference was statistically significant(χ~2=6.76,P=0.009).According to the clinical diagnosis and follow-up results,the sensitivity,specificity,positive predictive value and negative predictive value of brain CTP combined with head and neck CTA were 94%,83%,97%and71%,respectively.Conclusion Brain CTP combined with head-neck CTA examination has high value in the evaluation of early AIS,and can provide the basis for clinical timely treatment.

关 键 词：体层摄影术 X线计算机 颅脑照射 血管造影术 卒中 

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]