多时相头CT血管造影联合CT灌注成像评估急性缺血性脑卒中患者侧支循环中的应用价值  

The Value of Multitemporal Head CT Angiography Combined with CT Perfusion Imaging in Assessing Collateral Circulation in Patients with Acute Ischemic Stroke

作　　者：汪欣[1] 马宝新[1] Wang Xin;Ma Baoxin(Department of Radiology,The First People’s Hospital of Huizhou,Huizhou,Guangdong,516001,China)

机构地区：[1]惠州市第一人民医院放射科,广东惠州516001

出　　处：《黑龙江医学》2023年第17期2113-2115,2119,共4页Heilongjiang Medical Journal

基　　金：惠州市科技计划项目(210419174570111)。

摘　　要：目的:探讨多时相头CT血管造影(MP-CTA)联合CT灌注成像(CTP)评估急性缺血性脑卒中(AIS)患者侧支循环中的应用价值以及应用评估急性缺血性脑卒中患者侧支循环情况。方法:选取2021年6月—2022年3月惠州市第一人民医院收治的40例急性缺血性脑卒中患者均给予CTP、MP-CTA诊断,对比MP-CTA诊断与CTP诊断一致性,比较侧支循环组与无侧支循环组患者入院时、入院2周时及随访3个月后美国国立卫生研究院卒中量表(NIHSS)评分。结果:经检验,两种方法诊断缺血性脑卒中侧支循环Kappa值为0.765,MP-CTA诊断缺血性脑卒中侧支循环的灵敏度为86.36%,特异度为88.89%,阳性预测值为90.48%,阴性预测值为84.21%,准确度为87.50%。侧支循环组与无侧支循环组患者入院时NIHSS评分比较,差异无统计学意义(P>0.05);入院2周后及随访3个月后侧支循环组患者NIHSS评分显著低于无侧支循环组患者,差异有统计学意义(t=15.294、18.473,P<0.05)。结论:MP-CTA诊断AIS患者侧支循环灵敏度、特异度较高,且图像更具有典型性,可与CTP联合应用评估急性缺血性脑卒中患者侧支循环情况。Objective:To investigate the value of multitemporal head CT angiography(MP-CTA)combined with CT perfusion imaging(CTP)in assessing collateral circulation in patients with acute ischemic stroke(AIS)and its application to assess collateral circulation in patients with acute ischemic stroke.Methods:40 patients with acute ischemic stroke admitted to the hospital from June 2021 to March 2022 were selected,and all were given CTP and MP-CTA diagnosis.The diagnostic agreement between MP-CTA diagnosis and CTP was compared,and the NIHSS scores at admission,at 2 weeks of admission and after 3 months of follow-up were compared between patients in the collateral circulation group and those in the no collateral circulation group.Results:The Kappa value for the diagnosis of ischemic stroke collateral circulation by the two methods tested was 0.765.The sensitivity of MP-CTA for the diagnosis of ischemic stroke collateral circulation was 86.36%,the specificity was 88.89%,the positive predictive value was 90.48%,the negative predictive value was 84.21%,and the accuracy was 87.50%.There was no statistically significant difference in NIHSS scores at admission between patients in the collateral circulation group and those in the no collateral circulation group(P>0.05).After 2 weeks of admission and 3 months of follow-up,the NIHSS scores in the group with collateral circulation were significantly lower than those in the group without collateral circulation,with statistically significant differences(t=15.294,18.473,P<0.05).Conclusion:MP-CTA has higher sensitivity and specificity in diagnosing collateral circulation in patients with AIS,and the images are more typical,so it can be used in combination with CTP to assess collateral circulation in patients with acute ischemic stroke.

关 键 词：急性缺血性脑卒中 多时相头CT血管造影 CT灌注成像技术 侧支循环 

分 类 号：R445[医药卫生—影像医学与核医学]