CT灌注成像联合CT血管造影对TIA患者进展为急性脑梗死的预测  

Value of CT perfusion imaging combined with CT angiography in predicting the progression of TIA patients to acute cerebral infarction

作　　者：季鹏 郭言言 王超[1] Peng Ji;Yanyan Guo;Chao Wang(Imaging Department,Bozhou People's Hospital,Anhui Bozhou 236800,China)

机构地区：[1]亳州市人民医院南院影像科,安徽亳州236800

出　　处：《中华介入放射学电子杂志》2023年第2期128-132,共5页Chinese Journal of Interventional Radiology：electronic edition

基　　金：中国红十字基金会"医学赋能-领航菁英科研项目"(XM_HR_YXFN_2021_05_24)。

摘　　要：目的探讨CT灌注成像联合CT血管造影对短暂性脑缺血发作(transient ischemic attack,TIA)患者进展为急性脑梗死(acute cerebral infarction,ACI)的预测价值。方法选取本院2019年3月—2022年8月收治的150例TIA患者,所有患者均在入院24 h内行CT灌注成像和CT血管造影检查,根据患者发病后7 d内是否发生ACI将其分为ACI组和非ACI组。对比ACI组和非ACI组CT灌注成像参数[脑血容量(cerebral blood volume,CBV)、脑血流量(cerebral blood flow,CBF)、平均通过时间(mean transit time,MTT)、达峰时间(time to peak,TTP)]及血管造影特征。绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析CT灌注成像联合CT血管造影对TIA患者进展为ACI的预测价值。结果TIA患者ACI发生率为18.67%(28/150);ACI组CBV、CBF均低于非ACI组(P<0.05),MTT、TTP均高于非ACI组(P<0.05);ACI组血管狭窄程度高于非ACI组(P<0.05);CBV、CBF、MTT、TTP联合预测TIA患者进展为ACI的灵敏度、特异度和曲线下面积(area under the curve,AUC)分别为78.57%、88.52%和0.824,联合预测的AUC均高于单独预测;CT灌注成像联合CT血管造影预测TIA患者进展为ACI的AUC和灵敏度均高于单独预测(P<0.05),特异度与单独预测对比无统计学差异(P>0.05)。结论CT灌注成像和CT血管造影对TIA患者进展为ACI有一定的预测价值,但联合预测价值更高。Objective To investigate the value of CT perfusion imaging combined with CT angiography in predicting the progression of transient ischemic attack(TIA)to acute cerebral infarction(ACI).Methods 150 patients with TIA admitted to our hospital from March 2019 to August 2022 were selected.All patients underwent CT perfusion imaging and CT angiography within 24 hours after admission.They were divided into ACI group and non-ACI group according to whether ACI occurred within 7 days after the onset of the disease.CT perfusion imaging parameters[cerebral blood volume(CBV),cerebral blood flow(CBF),mean transit time(MTT),time to peak(TTP)]and angiographic characteristics were compared between ACI group and non-ACI group.Draw receiver operating characteristic(ROC)curve to analyze the predictive value of CT perfusion imaging combined with CT angiography for TIA patients'progression to ACI.Results The incidence of ACI in TIA patients was 18.67%(28/150).CBV and CBF in ACI group were lower than those in non ACI group(P<0.05),and MTT and TTP were higher than those in non ACI group(P<0.05).The degree of vascular stenosis in ACI group was higher than that in non ACI group(P<0.05).The sensitivity,specificity and area under the curve(AUC)of CBV,CBF,MTT and TTP in predicting the progression of TIA patients to ACI were 78.57%,88.52%and 0.824 respectively,and the AUC predicted by CBV,CBF,MTT and TTP was higher than that predicted alone.The AUC and sensitivity of CT perfusion imaging combined with CT angiography in predicting the progression of TIA to ACI were higher than those predicted alone(P<0.05),but there was not statistically significant compared with that predicted alone(P>0.05).Conclusions CT perfusion imaging and CT angiography have a certain predictive value for the progression of TIA patients to ACI,but the combined predictive value is higher.

关 键 词：CT灌注成像 CT血管造影 短暂性脑缺血发作 急性脑梗死 预测价值 

分 类 号：R743.33[医药卫生—神经病学与精神病学]