多模态CT的ASPECTS评分预测颅内动脉粥样硬化狭窄相关急性大血管闭塞患者预后的价值  

Value of ASPECTS on Multimodal CT Scan in Predicting the Prognosis of Patients with Large Vessel Occlusion Related Acute Ischemic Strokes Caused by Intracranial Atherosclerotic Stenosis

作　　者：熊亮 李胜[1] 曹阳[1] 曾蕾 XIONG Liang;LI Sheng;CAO Yang(Department of Radiology,Shiyan People's Hospital,Shiyan,Hubei Province 422000,P.R.China)

机构地区：[1]湖北省十堰市人民医院放射科,422000

出　　处：《临床放射学杂志》2023年第7期1062-1065,共4页Journal of Clinical Radiology

摘　　要：目的研究多模态CT的Alberta卒中早期CT评分(ASPECTS)在预测颅内动脉粥样硬化狭窄(ICAS)相关急性大血管闭塞性缺血性脑卒中(AIS-LVO)患者预后的价值。方法搜集96例ICAS相关AIS-LVO患者纳为研究对象,患者行血管内治疗前后均接受多模态CT检查,随访90天,根据mRS评分将其分为预后良好组(mRS≤2分)及预后不良组(mRS>2分),分析入院时多模态CT ASPECTS在评估患者预后中的价值。结果预后良好组入院时及复诊时CT平扫ASPECTS高于预后不良组,两组复诊时CT平扫ASPRCTS均低于其同组入院时评分,差异具有统计学意义(P<0.05)。预后良好组入院时及复诊CTA ASPECTS均高于预后不良组,差异具有统计学意义(P<0.05),两组复诊时CTA ASPECTS与其入院时水平比较,差异均无统计学意义(P>0.05)。患者入院时CT平扫及CTA ASPECTS均与其复诊ASPECTS评分之间呈正相关(P<0.05)。绘制ROC曲线发现,术前CT平扫ASPECTS低于6.75分,术前CTA ASPECTS评分低于6.45分,在评估ICAS相关AIS-LVO患者预后中均具有一定的潜能[AUC=0.768,95%CI(0.671~0.865),AUC=0.761,95%CI(0.660~0.863)],而两者联合应用对AIS-LVO患者预后判断中的效能更高[AUC=0.886,95%CI(0.816~0.955)]。结论多模态CT ASPECTS操作简单方便,有助于ICAS相关AIS-LVO患者病情及预后评估。Objective To evaluate the value of Alberta Stroke Program Early CT Score(ASPECTS)on multimodal computed tomography(CT)scan in predicting the prognosis of patients with large-vessel occlusion-related acute ischemic strokes(AIS-LVO)caused by intracranial atherosclerotic stenosis(ICAS).Methods Ninety-six patients with ICAS-LVO in our hospital from January 2021 to January 2022 were enrolled.All patients underwent multimodal CT examinations before and after endovascular procedures.Patients were followed up for 90 days,and were divided into good prognosis group(mRS≤2 points)and poor prognosis group(mRS>2 points)according to modified Rankin scale(mRS)score.The value of ASPECTS on multimodal CT scan at admission in predicting the prognosis of patients with ICAS-LVO was evaluated.Results ASPECTS scores on CT plain scan of good prognosis group were higher than those of poor prognosis group at admission and return visit.Compared with data at admission,ASPECTS scores on CT plain scan at return visit were decreased in both groups,with statistical difference(P<0.05).The computed tomography angiography(CTA)ASPECTS scores in good prognosis group were higher than those in poor prognosis group at admission and return visit(P<0.05).The CTA ASPECTS scores at admission yielded no statistical difference with those at return visit(P<0.05).ASPECTS scores on CT plain scan and CTA at admission were positively correlated with the ASPECTS score at return visit(P<0.05).Receiver Operating Characteristic(ROC)curve found preoperative ASPECTS on CT plain scans below 6.75 and preoperative ASPECTS on CTA scans below 6.45.The ASPECTS on both CT plain and CTA scans had potential in assessing the prognosis of patients with ICAS-related AIS-LVO[AUC=0.768,95%CI(0.671-0.865),AUC=0.761,95%CI(0.660-0.863)],and the combined application of the two achieved better diagnostic efficacy in determining the prognosis of patients with ICAS-related AIS-LVO than that of separate application[AUC=0.886,95%CI(0.816-0.955)].Conclusion ASPECTS scores on multimodal CT s

关 键 词：颅内动脉粥样硬化狭窄 急性大血管闭塞性缺血性脑卒中 多模态CT 预后分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]