双能CT融合图像的延迟点征对缺血性卒中介入术后颅内出血的预测价值  

Prediction of Delayed Point Sign of Dual-Energy Computed Tomography Fusion Images in Patient with Intracranial Hemorrhage After Interventional Ischemic Stroke

作　　者：何晓清[1] 梁汉欢[1] 戴顺钦 刘海安 黄丹丹[2] 黄汉宁[2] HE Xiaoqing;LIANG Hanhuan;DAI Shunqin;LIU Haian;HUANG Dandan;HUANG Hanning(Department of Imaging,People's Hospital of Gaozhou City,Guangdong Province,Gaozhou 525200,China;不详)

机构地区：[1]广东省高州市人民医院影像科,广东高州525200 [2]广东省高州市人民医院神经内科,广东高州525200

出　　处：《中国医学影像学杂志》2022年第10期986-990,995,共6页Chinese Journal of Medical Imaging

基　　金：广东省医学科学技术研究基金(A2020218);广东省茂名市科技计划(190404151701037)。

摘　　要：目的评价缺血性卒中介入术后1 h内双能CT融合图像上出现的延迟点征对术后颅内出血的预测价值。资料与方法回顾性分析2019年5月—2020年11月高州市人民医院167例缺血性卒中患者介入术后1 h内双源CT双能量扫描检查结果,由2名放射科医师根据延迟点征的判断标准进行判读,以术后24~72 h的CT平扫或MRI检查有无术后颅内出血为标准,分为术后出血组与术后无出血组,评价融合图像的延迟点征预测术后出血的价值,对组间基线资料差异有统计学意义的因素进行二分类Logistic回归分析,明确融合图像的延迟点征与术后出血的相关性。结果延迟点征影像学结果判读的一致性高(Kappa=0.946,P<0.001),167例患者中术后出血42例(25.15%),延迟点征阳性57例(34.13%),42例术后出血患者中38例(90.48%)出现延迟点征,延迟点征预测术后出血的敏感度为90.5%(38/42)、特异度为84.8%(106/125)、假阳性率为15.2%(19/125)、假阴性率为9.5%(4/42)、阳性预测率为66.7%(38/57)、阴性预测率为96.4%(106/110)、准确度为86.2%(144/167)。Logistic回归分析显示、延迟点征是预测术后颅内出血的独立影像征象(OR=51.36,95%CI 16.15~163.30,P<0.001)。结论缺血性卒中介入术后1 h内双能CT融合图像出现的延迟点征可以预测术后颅内出血,有助于筛选可能发生术后颅内出血的高危患者。Purpose To evaluate the predictive value of delayed point signal of dual-energy computed tomography(CT)fusion images within 1 hour after ischemic stroke intervention surgery for postoperative intracranial hemorrhage.Materials and Methods A total of 167 patients with ischemic stroke who underwent dual-energy CT scans within 1 hour after ischemic stroke intervention surgery in Gaozhou People's Hospital from May 2019 to November 2020 were retrospectively enrolled.The delayed point signal findings were interpreted by two experienced radiologists.Based on intracranial hemorrhage identified by CT or MRI within 24 to 72 hours after the surgery,all patients were divided into two groups,including postoperative bleeding group and postoperative non-bleeding group.The value of the delayed point signal for the fusion images in predicting postoperative bleeding was evaluated.Moreover,binary logistic regression analysis was performed on the significantly different baseline data to clarify the correlation between delayed point signal findings and postoperative bleeding.Results The interpretation of delayed point signal finding was presented with high consistency(Kappa=0.946,P<0.001).Of all 167 patients,there were 42 patients(25.15%)with postoperative bleeding and 57 patients(34.13%)with positive delayed point signal.In addition,of 42 patients with postoperative bleeding,there were 38 cases(90.48%)with delayed point signal finding.The sensitivity,specificity,false positive rate,false negative rate,positive prediction rate,negative prediction rate and accuracy of delayed point signal was 90.5%(38/42),84.8%(106/125),15.2%(19/125),9.5%(4/42),66.7%(38/57),96.4%(106/110)and 86.2%(144/167)in predicting postoperative bleeding,respectively.The delayed point signal was considered as the independent predictive factor on postoperative intracranial hemorrhage via logistic regression analysis(OR=51.36,95%CI 16.15-163.30,P<0.001).Conclusion The delayed point sign of dual-energy CT fusion images within 1 hour after ischemic stroke intervention

关 键 词：卒中 体层摄影术 X线计算机 介入治疗 预测 

分 类 号：R445.3[医药卫生—影像医学与核医学] R816[医药卫生—诊断学]