多层CT全脑灌注成像技术对急性脑梗死的诊断效果分析  

Analysis of the diagnostic effect of multi-slice CT whole brain perfusion imaging technology on acute cerebral infarction

作　　者：姜红坚 田文飞 王树文[1] 朱环宇 Jiang Hongjian;Tian Wenfei;Wang Shuwen;Zhu Huanyu(Department of Imaging,Guanyun County People′s Hospital of Jiangsu Province,Lianyungang 222200,China)

机构地区：[1]江苏省连云港市灌云县人民医院影像科,222200 [2]江苏省连云港市灌云县人民医院神经内科,222200

出　　处：《实用医学影像杂志》2024年第2期94-98,共5页Journal of Practical Medical Imaging

摘　　要：目的探讨多层CT全脑灌注成像技术在急性脑梗死诊断中的效果。方法选取2021年1月至2022年12月本院收治的73例高度疑似急性脑梗死患者作为研究对象,所有研究对象均表现出不同程度的脑梗死临床症状,使用双源螺旋CT机对患者进行头颅CT平扫和CT灌注成像,对患者的病情进行诊断,采用磁共振成像(MRI)作为金标准,并将2种方法检查诊断结果进行比较;比较多层CT全脑灌注成像技术与MRI对患者梗死部位诊断的结果;比较急性脑梗死患者核心梗死区、梗死周边和健侧镜像区的脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)和达峰所需时间(TTP)等脑灌注参数。结果MRI结果显示73例患者有70例确诊为急性脑梗死,多层CT全脑灌注成像技术结果显示,73例患者中有67例被确诊为急性脑梗死,3例漏诊,准确率为96%,1种方法诊断的Kappa值为0.647,一致性较高;MRI诊断结果显示,70例急性脑梗死患者中有27例丘脑-基底节区梗死、13例脑干梗死、18例单个脑叶梗死,12例大面积梗死,诊断准确率为100%。多层CT全脑灌注成像技术诊断结果为29例丘脑-基底节区梗死、12例脑干梗死、15例单个脑叶梗死,12例大面积梗死,4例漏诊,2例误诊,诊断准确率为91%,2种方法诊断的准确率比较差异无统计学意义(χ^(2)=0.34,P>0.05);多层CT灌注成像技术测定核心梗死区、梗死周边以及健侧镜像区灌注参数显示,核心梗死区、梗死周边和健侧镜像区的CBF、CBV、TTP、MTT差异具有统计学意义(P<0.05)。梗死周边的CBF、CBV水平低于健侧镜像区(P<0.05),TTP、MTT水平低于高于健侧镜像区(P<0.05)。与梗死周边和健侧镜像区相比,核心梗死区的TTP、MTT水平升高(P<0.05),CBF、CBV水平降低(P<0.05)。结论多层CT全脑灌注成像技术评估诊断急性脑梗死的准确率较高,在临床上具有较高的应用推广价值。Objective To explore the effectiveness of multi-slice CT whole brain perfusion imaging technology in the diagnosis of acute cerebral infarction.Methods From January 2021 to December 2022,73 highly suspected acute cerebral infarction patients accepted by our hospital were collected as the study subjects,all of whom exhibited varying degrees of clinical symptoms of cerebral infarction,the dual source spiral CT machine was applied to patients for head CT plain scan and CT perfusion imaging to diagnose the patients′condition,magnetic resonance imaging(MRI)was used as the gold standard method and the diagnostic results of the two methods were compared.The results of multi-slice CT whole brain perfusion imaging technology and MRI in diagnosing the infarct site of patients were compared.The cerebral perfusion parameters such as cerebral blood volume(CBV),cerebral blood flow(CBF),mean transit time(MTT),and time to peak(TTP)were compared in the core infarct area,periinfarct area,and contralateral mirror area of acute cerebral infarction patients.Results MRI showed that 70 out of 73 patients were diagnosed with acute cerebral infarction,multi-slice CT whole brain perfusion imaging technology showed that 67 out of 73 patients were diagnosed with acute cerebral infarction,and 3 were missed,with an accuracy rate of 96%,the Kappa value of the two methods for diagnosis was 0.647,indicating high consistency.The MRI diagnostic results showed that among 70 patients with acute cerebral infarction,there were 27 cases with thalamic basal ganglia infarction,13 cases with brainstem infarction,18 cases with single lobe infarction,and 12 cases with large area infarction,with a diagnostic accuracy of 100%.The diagnostic results of multi-slice CT whole brain perfusion imaging technology were 29 cases with thalamic basal ganglia infarction,12 cases with brainstem infarction,15 cases of single lobe infarction,12 cases withlarge area infarction,4 cases with missed diagnosis,2 cases with misdiagnosis,the diagnostic accuracy rate was 91%,and

关 键 词：急性脑梗死 灌注成像 诊断 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R816.1[医药卫生—临床医学]