探讨CT灌注成像(CTP)联合CT血管造影(CTA)对短暂性脑缺血发作(TIA)患者进展为急性脑梗死(ACI)的预测价值  

To Explore The Predictive Value of CT Perfusion Imaging(CTP)Combined with CT Angiography(CTA)in The Progression of Acute Cerebral Infarction(ACI)in Patients with Transient Ischemic Attack(TIA)

作　　者：张园园 任思勰 李盼盼 张新宇[2] Zhang Yuan-yuan;Ren Si-xie;Li Pan-pan;Zhang Xin-yu(Imaging Department of Chengdu Second People's Hospital,Jinjiang 610017,Chengdu Province,China;Neurosurgery Department of the Second People's Hospital of Chengdu,Jinjiang 610017,Chengdu Province,China)

机构地区：[1]成都市第二人民医院影像科,成都锦江610017 [2]成都市第二人民医院神经外科,成都锦江610017

出　　处：《中国CT和MRI杂志》2023年第7期27-29,共3页Chinese Journal of CT and MRI

基　　金：2021年度科研苗圃计划专项基金课题编号或审批号:成二院科〔2020〕27号-16。

摘　　要：目的探讨CT灌注成像(CTP)联合CT血管造影(CTA)对短暂性脑缺血发作(TIA)患者进展为急性脑梗死(ACI)的预测价值。方法选取本院2020年1月~2022年1月收治的80例TIA患者,所有患者均在入院24h内行CTP和CTA检查,根据患者发病后7d内是否发生ACI将其分为ACI组和非ACI组。对比ACI组和非ACI组CTP参数[脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)、达峰时间(Tmax)]及CTA特征。绘制受试者工作特征(ROC)曲线,分析CTP联合CTA对TIA患者进展为ACI的预测价值。结果TIA患者ACI发生率为16.25%(13/80);ACI组CBV、CBF均低于非ACI组(P<0.05),MTT、Tmax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、Tmax联合预测TIA患者进展为ACI的灵敏度、特异度和曲线下面积(AUC)分别为84.62%、88.06%和0.821,联合预测的AUC均高于单独预测;CTP和CTA联合预测TIA患者进展为ACI的灵敏度、特异度和AUC分别为100%、86.57%和0.939,联合预测的AUC均高于单独预测。结论CTP和CTA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(CTP)combined with CT angiography(CTA)in predicting the progression of transient ischemic attack(TIA)to acute cerebral infarction(ACI).Methods 80 patients with TIA treated in our hospital from January 2020 to January 2022 were selected.All patients underwent CTP and CTA within 24 hours after admission.According to whether ACI occurred within 7 days after onset,they were divided into ACI group and non ACI group.CTP parameters[including cerebral blood volume(CBV),cerebral blood flow(CBF),mean transit time(MTT),time to maximum(Tmax)]and CTA characteristics were compared between ACI group and non ACI group.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of CTP combined with CTA in the progression of TIA patients to ACI.Results The incidence of ACI in TIA patients was 16.25%(13/80).CBV and CBF in ACI group were lower than those in non ACI group(P<0.05),and MTT and Tmax 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 Tmax in predicting the progression of TIA patients to ACI were 84.62%,88.06%and 0.821 respectively,and the AUC predicted by CBV,CBF,MTT and Tmax was higher than that predicted alone.The sensitivity,specificity and AUC of CTP combined with CTA in predicting the progression of TIA to ACI were 100%,86.57%and 0.939 respectively,and the AUC predicted by CTP combined with CTA was higher than that predicted alone.Conclusion CTP and CTA 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 预测价值短暂性脑缺血发作 急性脑梗死 

分 类 号：R814.43[医药卫生—影像医学与核医学]