急性缺血性脑卒中改良ASITN/SIR侧支循环评分与CTP灌注参数的相关性分析  

Correlation analysis of modified ASITN/SIR collateral circulation score and CTP perfusion parameters in acute ischemic stroke

作　　者：石容容 袁巍[1] 陆悌明 徐秋贞[1] SHI Rongrong;YUAN Wei;LU Diming;XU Qiuzhen(Department of Radiology,Jiangbei Hospital,Zhongda Hospital Affiliated to Southeast University,Nanjing 211500,China)

机构地区：[1]东南大学附属中大医院江北院区放射科,江苏南京211500

出　　处：《医学影像学杂志》2023年第11期1954-1958,共5页Journal of Medical Imaging

基　　金：江苏省医学会伦琴影像科研专项资金项目[编号:SYH-3201150-0009(2021004)]。

摘　　要：目的探讨急性缺血性脑卒中(AIS)改良美国介入和治疗神经放射学协会/介入放射学协会(ASITN/SIR)侧支循环评分与CT灌注成像(CTP)参数的相关性。方法选取我院急诊入院且发病时间<6 h的AIS患者192例,均进行多模态CT检查。统计基于CTA下改良ASITN/SIR侧支循环评分评估侧支循环,分析侧支循环情况与CTP灌注参数。结果192例AIS患者侧支循环良好127例(占66.1%,侧支循环良好组),侧支循环差65例(33.9%,侧支循环差组),每例患者CT检查的总辐射剂量范围为4.9~6.2 mSv,平均为5.9 mSv;改良ASITN/SIR侧支循环评分与梗死核心体积差异有统计学意义(Spearman’s rho=-0.469,P=0.005<0.05),与低灌注区及严重低灌注区均差异有统计学意义(Spearman’s rho分别为-0.314、-0.429,P分别为0.040、0.009,均<0.05),与不匹配率差异有统计学意义(Spearman’s rho=0.308,P=0.038<0.05);相对于侧支循环良好组,侧支循环差组患者梗死核心、低灌注及严重低灌注区体积明显更大,差异有统计学意义(P<0.05),不匹配率、相对脑血流量、相对脑血容量、相对平均通过时间及相对最大峰值时间明显更低(或小),差异有统计学意义(P<0.05)。结论基于CTA的改良ASITN/SIR侧支循环评分可较好地评估AIS患者侧支循环状态,且改良ASITN/SIR侧支循环评分与CTP灌注参数显著相关。Objective To analyze the correlation between the modified american society of interventional and therapeutic neuroradiology/society of interventional radiology(ASITN/SIR)collateral circulation score and computed tomography perfusion(CTP)parameters in acute ischemic stroke(AIS).Methods A total of 192 AIS patients admitted to the emergency department of our hospital from September 2018 to September 2020 with onset time less than 6h were selected for multimodal CT examination.Collateral circulation was statistically evaluated based on the modified ASITN/SIR collateral circulation score under CTA,and collateral circulation and CTP perfusion parameters were analyzed.Results Among the 192 AIS patients,127 had good collateral circulation(66.1%,the group with good collateral circulation)and 65 had poor collateral circulation(33.9%,the group with poor collateral circulation).The total radiation dose of each patient in CT examination ranged from 4.9 to 6.2 mSv,with an average of 5.9 mSv;The modified ASITN/SIR collateral circulation score was significantly negatively correlated with the infarction core volume(Spearman’s rho=-0.469,P=0.005<0.05),and was significantly negatively correlated with both low perfusion area and severe low perfusion area(Spearman’s rho was-0.314,-0.429,respectively).P=0.040,0.009,both<0.05),and was positively correlated with the mismatch rate(Spearman’s rho=0.308,P=0.038<0.05);Compared with the good collateral circulation group,the infarction core,the volume of low perfusion and severely low perfusion area in the poor collateral circulation group were significantly larger(all P<0.05),and the mismatch rate,relative cerebral blood flow,relative cerebral blood volume,relative mean passage time and relative maximum peak time were significantly lower(all P<0.05).Conclusion The improved ASITN/SIR collateral circulation score based on CTA can better evaluate the collateral circulation status of AIS patients,and the improved ASITN/SIR collateral circulation score is significantly correlated with CTP p

关 键 词：急性缺血性脑卒中 侧支循环 灌注成像 体层摄影术 X线计算机 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R814.42[医药卫生—临床医学]