CT灌注联合血管成像预测急性脑梗死患者近期神经功能预后的价值分析  

Value analysis of CT perfusion combined with angiography in predicting prognosis of neurological function in patients with acute cerebral infarction

作　　者：马丽[1] Ma Li(Department of Imaging,the First People's Hospital of Xuzhou,Xuzhou 221000,China)

机构地区：[1]徐州市第一人民医院影像科,江苏徐州221000

出　　处：《中华脑科疾病与康复杂志（电子版）》2023年第4期229-234,共6页Chinese Journal of Brain Diseases and Rehabilitation（Electronic Edition）

摘　　要：目的探讨CT灌注(CTP)联合CT血管成像(CTA)对急性脑梗死(ACI)患者近期神经功能预后的预测价值。方法选取徐州市第一人民医院自2018年12月至2022年4月收治的232例ACI患者为研究对象,均在入院24 h内行CTP成像和CTA检查,并记录CTP成像各参数值和Alberta卒中项目早期CT评分(ASPECTS)。根据治疗后3个月改良Rankin量表评分将患者分为预后良好组和预后不良组。比较2组患者一般资料及CTP成像参数值、ASPECTS分值,绘制受试者工作特征曲线分析CTP成像联合CTA对ACI患者近期神经功能预后的预测价值。结果232例ACI患者治疗后随访3个月发生神经功能预后不良51例,总发生率为21.98%;与预后良好组比较,预后不良组美国国立卫生研究院卒中量表评分、达峰时间、平均通过时间均升高,ASPECTS分值、脑血容积、脑血流量均降低,差异均具有统计学意义(P<0.05);CTP成像参数联合预测、CTP成像联合CTA预测ACI患者近期神经功能预后不良的灵敏度分别为74.51%、90.20%,曲线下面积分别为0.820、0.919,均高于单独预测,且CTP成像联合CTA预测优于CTP成像参数联合预测,差异具有统计学意义(P<0.05);其特异度比较,差异无统计学意义(P>0.05)。结论CTP成像和CTA均可预测ACI患者近期神经功能预后,但二者联合预测价值更高。Objective To explore the value of CT perfusion(CTP)combined with angiography(CTA)in predicting neurological prognosis in patients with acute cerebral infarction(ACI)in the near future.Methods Two hundred and thirty-two ACI patients admitted to Xuzhou First People's Hospital from December 2018 to April 2022 were selected as the study subjects,all of whom underwent CTP imaging and CTA examination within 24 h of admission,and the CTP parameters and Alberta stroke early CT score(ASPECTS)were recorded.They were divided into good/poor prognosis group according to the score results of modified Rankin scale(mRS)at 3 months after treatment.The general data,CTP imaging parameters and ASPECTS scores of the two groups were compared.The receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of CTP combined with CTA for neurological prognosis in ACI patients in the near future.Results Two hundred and thirty-two patients with ACI were followed up for 3 months after treatment,51 patients had poor prognosis of neurological function,and the total incidence was 21.98%.Compared with the good prognosis group,the poor prognosis group showed an increase in the National Institutes of Health stroke scale score,time to peak,and mean transit time(P<0.05),while ASPECTS score,cerebral blood volume,and cerebral blood flow decreased(P<0.05).The sensitivity and area under the curve of CTP imaging parameters in predicting the poor prognosis of neurological function in patients with ACI respectively were 74.51% and 0.820,which were higher than those predicted alone.The sensitivity and AUC of CTP combined with CTA in predicting the poor prognosis of neurological function in patients with ACI respectively were 90.20% and 0.919,which were higher than those predicted alone(P<0.05),and the specificity was not statistically significant compared with that predicted alone(P>0.05).Conclusion Both CTP imaging and CTA can predict poor neurological prognosis in ACI patients in the near future,but the combined predictive value o

关 键 词：急性脑梗死 CT灌注成像 CT血管成像 神经功能 预后不良 预测价值 

分 类 号：R743.3[医药卫生—神经病学与精神病学]