脑部CT及MRI在脑血管取栓术中的评估应用  

Evaluation and Application of Brain CT and MRI in Cerebral Vascular Thrombectomy

作　　者：钟景云[1] 鲁俊 苏佳娜 ZHONG Jing-yun;LU Jun;SU Jia-na(Department of Radiology,People's Hospital of Xinhui District,Jiangmen City,Guangdong 529100,China)

机构地区：[1]江门市新会区人民医院放射科,广东529100

出　　处：《影像技术》2023年第1期10-15,共6页Image Technology

基　　金：江门市科学技术局医疗卫生领域科技计划项目(2021YL08022)。

摘　　要：目的:分析脑部CT及MRI在脑血管取栓术中的评估应用。方法:选定江门市新会区人民医院2019年1月至2022年8月住院的28例脑血管取栓术患者,手术前后分别进行脑CT灌注(CTP)成像检查、磁共振(MR)弥散加权成像(DWI)检查,比较治疗前后CTP灌注参数、MR-DWI表观扩散系数(ADC)值,对28例患者进行为期90d的随访,以mRS评分分为预后不良组(mRS评分>2分,5例)、预后良好组(mRS评分≤2分,23例),比较预后不良组、预后良好组CTP灌注参数、MR-DWIADC值。绘制ROC曲线,比较CTP、MR-DWI对脑血管取栓术患者预后预测价值。结果:治疗后TTP、MTT、CBV均低于治疗前,治疗后CBF高于治疗前,P<0.05(差异均具有统计学意义)。治疗后MR-DWIADC值均高于治疗前,P<0.05(差异均具有统计学意义)。预后良好组TTP、MTT、CBV均低于预后不良组,预后良好组CBF高于预后不良组,P<0.05(差异均具有统计学意义)。预后良好组MR-DWIADC值均高于预后不良组,P<0.05(差异均具有统计学意义)。脑部CT及MRI对脑血管取栓术患者预后预测灵敏度(82.1%、86.2%)、特异度(80.6%、84.9%)比较,P>0.05(AUC=0.516、0.507)。结论:CTP成像以及MR-DWI均可对脑血管取栓术患者治疗效果及预后作出评价,通过测量CTP成像灌注参数以及ADC值,可准确评估治疗效果,CTP成像以及MR-DWI在预测脑血管取栓术患者预后方面的灵敏度、特异度相当,临床医生可结合患者实际情况针对性地选择检查方法。Objective:To analyze brain CT and MRI in cerebral vascular thrombectomy.Methods:Twenty-eight patients with cerebral vascular thrombectomy who were hospitalized in Xinhui District People's Hospital of Jiangmen City from January 2019 to August 2022 were selected,and underwent cerebral CT perfusion(CTP)imaging and magnetic resonance(MR)diffusion-weighted imaging(DWI)before and after the operation.CTP perfusion parameters and MR-DWI apparent diffusion coefficient(ADC)values before and after treatment were compared.28 patients were followed up for 90 days,and they were divided into poor prognosis group(mRS score>2 points,5 cases)and good prognosis group(mRS score≤2 points,23 cases)according to mRS score.CTP perfusion parameters and MR-DWI ADC values were compared between poor prognosis group and good prognosis group.The ROC curve was drawn to compare the prognostic value of CTP and MR-DWI in patients undergoing cerebral thrombectomy.Results:After treatment,TTP,MTT,and CBV were all lower than those before treatment,and CBF after treatment was higher than before treatment,P<0.05(all differences were statistically significant).MR-DWIADC values after treatment were higher than those before treatment,P<0.05(both differences were statistically significant).TTP,MTT,and CBV in the good prognosis group were lower than those in the poor prognosis group,and the CBF in the good prognosis group was higher than that in the poor prognosis group,P<0.05(both differences were statistically significant).The MR-DWIADC values of the good prognosis group were higher than those of the poor prognosis group,P<0.05(all differences were statistically significant).The sensitivity(82.1%,86.2%)and specificity(80.6%,84.9%)of brain CT and MRI for prognosis prediction of patients undergoing cerebral vascular thrombectomy were compared,P>0.05(AUC=0.516,0.507).Conclusion:Both CTP imaging and MR-DWI can evaluate the treatment effect and prognosis of patients undergoing cerebral vascular thrombectomy.The treatment effect can be accurately evaluated by

关 键 词：脑CT灌注成像 磁共振弥散加权成像 脑血管取栓术 治疗效果 

分 类 号：R445.2[医药卫生—影像医学与核医学]