颅脑CT灌注成像参数与TIA患者颈动脉IMT的关系及对进展为急性脑梗死的预测价值分析  

The Relationship Between Cerebral CT Perfusion Imaging Parameters and Carotid IMT in Patients with TIA and Its Predictive Value for The Progression of Acute Cerebral Infarction

作　　者：赵静[1] 刘巧珍 苗耀巍 王帅 王友明[6] 唐英杰 Zhao Jing;Liu Qiao-zhen;Miao Yao-wei;Wang Shuai;Wang You-ming;Tang Ying-jie(Medical Imaging Department of Hebei Engineering University Affiliated Hospital,Handan 056000,Hebei Province,China;Medical Imaging Department of Qingyuan Traditional Chinese Medicine Hospital,Qingyuan 511500,Guangdong Province,China;Functional Department of Qingyuan Traditional Chinese Medicine Hospital,Qingyuan 511500,Guangdong Province,China;CT Room of Linzhang County Hospital in Handan City,Handan 056600,Hebei Province,China;Functional Department of Hebei Engineering University Affiliated Hospital,Handan 056000,Hebei Province,China;Department of Neurology,Affiliated Hospital of Hebei Engineering University,Handan 056000,Hebei Province,China)

机构地区：[1]河北工程大学附属医院医学影像科,河北邯郸056000 [2]清远市中医院医学影像科,广东清远511500 [3]清远市中医院功能科,广东清远511500 [4]邯郸市临漳县医院CT室,河北邯郸056600 [5]河北工程大学附属医院功能科,河北邯郸056000 [6]河北工程大学附属医院神经内科,河北邯郸056000

出　　处：《中国CT和MRI杂志》2023年第10期36-38,共3页Chinese Journal of CT and MRI

基　　金：邯郸市科学技术研究与发展计划项目(21422083357)。

摘　　要：目的 探讨颅脑CT灌注成像(CTP)参数与短暂性脑缺血发作(TIA)患者颈动脉内中膜(IMT)厚度的关系及对进展为急性脑梗死的预测价值。方法 选取我院与清远市中医院2019年1月~2022年8月收治的216例TIA患者,所有患者均在入院24h内行颅脑CTP检查,并采用彩色超声诊断仪测定颈动脉IMT值。TIA患者均接受随访3个月,根据随访期间有无进展为ACI将其分为ACI组和非ACI组。采用Pearson相关性分析法分析TIA患者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)]与颈动脉IMT的关系;对比ACI组和非ACI组CTP参数,绘制受试者工作特征(ROC)曲线分析CTP参数对TIA患者进展为ACI的预测价值。结果 216例TIA患者有36例进展为ACI,TIA患者ACI发生率为16.67%(36/216);ACI组CBV、CBF均低于非ACI组(P<0.05),MTT、Tmax、IMT值均高于非ACI组(P<0.05);Pearson相关性分析结果 显示,TIA患者CBV、CBF与颈动脉IMT呈负相关(P<0.05);MTT、Tmax与颈动脉IMT呈正相关(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94.44%、83.89%和0.869,联合预测的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 TIA进展为ACI患者相比未进展患者CBV、CBF降低,MTT、Tmax、IMT升高。TIA患者CTP参数CBV、CBF、MTT、Tmax与颈动脉IMT具有相关性,且CBV、CBF、MTT、Tmax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 relationship between cerebral CT perfusion imaging(CTP)parameters and carotid intima-media thickness(IMT)in patients with transient ischemic attack(TIA)and its predictive value for the progression of acute cerebral infarction.Methods 216 TIA patients treated in our hospital and Qingyuan Hospital of Traditional Chinese Medicine From January 2019 to August 2022 were selected.All patients were examined with brain CTP within 24 hours after admission,and carotid IMT values were measured with color ultrasound diagnostic instrument.TIA patients were followed up for 3 months,and they were divided into ACI group and non ACI group according to whether they progressed to ACI during the follow-up period.Pearson correlation analysis was used to analyze the relationship between CTP parameters[cerebral blood volume(CBV),cerebral blood flow(CBF),mean transit time(MTT),Maximum time(Tmax)]and carotid IMT in TIA patients.CTP parameters were compared between ACI group and non ACI group,and the ROC curve of subjects was drawn to analyze the predictive value of CTP parameters for TIA patients to develop into ACI.Results 36 of 216 TIA patients developed ACI,and the incidence of ACI in TIA patients was 16.67%(36/216).CBV and CBF in ACI group were lower than those in non ACI group(P<0.05),and MTT,Tmax and IMT were higher than those in non ACI group(P<0.05).Pearson correlation analysis showed that CBV,CBF in TIA patients were negatively correlated with carotid IMT(P<0.05),and MTT,Tmax were positively correlated with carotid IMT in TIA patients(P<0.05).The sensitivity,specificity and area under the curve(AUC)of the combined prediction of CBV,CBF,MTT and Tmax were 94.44%,83.89%and 0.869 respectively,and the AUC and sensitivity of the combined prediction were higher than those of the single prediction(P<0.05).There was no significant difference between the specificity and single prediction(P>0.05).Conclusion CBV and CBF of TIA patients with progression to ACI were lower than those of patients without progression,

关 键 词：CT灌注成像参数 短暂性脑缺血发作 颈动脉内中膜厚度 急性脑梗死 预测价值 

分 类 号：R743.31[医药卫生—神经病学与精神病学]