CT灌注成像联合galectin-3诊断术前肺癌纵隔淋巴结转移的效果  

The effect of CT perfusion imaging combined with galectin3 in the diagnosis of mediastinal lymph node metastasis in preoperative lung cancer

作　　者：张岩 徐祥辉[2] 李东[1] ZHANG Yan;XU Xianghui;LI Dong(CT Room,Xinxiang First People's Hospital,Xinxiang 453000,China)

机构地区：[1]新乡市第一人民医院CT室,河南新乡453000 [2]新乡市第一人民医院神经内科一病区,河南新乡453000

出　　处：《中风与神经疾病杂志》2024年第3期276-279,共4页Journal of Apoplexy and Nervous Diseases

摘　　要：目的 探讨基于CT观察颅内动脉粥样硬化和栓塞导致的急性椎基底动脉闭塞患者闭塞部位及血管内治疗近期预后特征。方法 选取2019年1月―2022年5月在新乡市第一人民医院治疗的急性椎基底动脉闭塞患者140例,根据病理机制,其中动脉粥样硬化性患者98例(A组),栓塞患者42例(B组),采用t检验或χ^(2)检验比较两组患者临床资料、闭塞部位、预后等,同时分析不同预后患者临床资料等差异,以及采用ROC曲线分析NIHSS评分、BATMAN评分预测患者预后不良的价值。结果 A组和B组性别、年龄、体质量指数、高血压、糖尿病、脑卒中史、发病至入院时间、美国国立卫生研究院卒中量表(NIHSS)评分和基底动脉计算机扫描血管造影(BATMAN)评分比较差异无统计学意义(P>0.05)。A组椎动脉V4段、基底动脉中段闭塞比例分别为41.84%、33.67%,明显高于B组(P<0.05);B组基底动脉上段闭塞比例为59.52%,明显高于A组(P<0.05);A组缺血半暗带体积、梗死核心体积分别为(46.64±15.44)ml、(20.10±9.92)ml,明显低于B组(P<0.05)。预后不良患者NIHSS评分为(24.41±2.09)分,明显高于预后良好患者(P<0.05),而BATMAN评分为(3.61±0.72)分,明显低于预后良好患者(P <0.05)。NIHSS评分、BATMAN评分预测患者预后不良的ROC曲线下面积分别为0.893、0.902,P<0.05,截断值分别为22分和5分,灵敏性分别为86.60%、92.70%,特异性分别为86.20%、77.60%。结论 颅内动脉粥样硬化和栓塞导致的急性椎基底动脉闭塞患者闭塞部位有明显差异,而预后情况无明显差异;NIHSS评分、BATMAN评分预测急性椎基底动脉闭塞患者预后有一定应用价值。Objective To investigate the characteristics of the occlusion site and the short-term prognosis of endovascular therapy in patients with acute vertebrobasilar artery occlusion caused by intracranial atherosclerosis and embolism based on computed tomography.Methods A total of 140 patients with acute vertebrobasilar artery occlusion treated in our hospital from January 2019 to May 2022 were selected.According to the pathological mechanism,there were 98 cases of atherosclerosis(group A)and 42 cases of embolism(group B).The clinical data,occlusion site,and prognosis of the two groups were compared using the t-test orχ^(2) test,and the differences in the clinical data of patients with different outcomes were analyzed.Receiver operating characteristic(ROC)curves were used to determine the value of the National Institutes of Health Stroke Scale(NIHSS)score and the Basilar Artery on Computed Tomography Angiography(BATMAN)score for predicting poor prognosis.Results There were no significant differences between group A and group B in sex,age,the body mass index,hypertension,diabetes,history of stroke,time from onset to admission,NIHSS score,and BATMAN score(P>0.05).The occlusion rates of the vertebral artery V4 segment and the middle basilar artery in group A were 41.84%and 33.67%respectively,which were significantly higher than those in group B(P<0.05).The proportion of upper basilar artery occlusion in group B was 59.52%,which was significantly higher than that in group A(P<0.05).The ischemic penumbra volume and infarct core volume in group A were(46.64±15.44)ml and(20.10±9.92)ml,respectively,which were significantly lower than those in group B(P<0.05).Patients with a poor prognosis had a significantly higher NIHSS score(24.41±2.09)points and a significantly lower BATMAN score(3.61±0.72)points than patients with a good prognosis(P<0.05).For NIHSS score and BATMAN score predicting a poor prognosis,the areas under the ROC curves were 0.893 and 0.902,the cut-off values were 22 and 5,the sensitivity values were 86.60%an

关 键 词：CT 颅内动脉粥样硬化 栓塞 急性椎基底动脉闭塞 预后 

分 类 号：R743[医药卫生—神经病学与精神病学]