CTA图像CT值方差比与急性大脑中动脉闭塞的短期预后相关性分析  

作　　者：应豪斌 顾水均 缪建庆 戴文斌 

机构地区：[1]浙江中医药大学第二临床医学院,310053 [2]杭州市萧山区第一人医院,311200

出　　处：《浙江临床医学》2024年第6期921-923,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨计算机断层扫描血管造影(CTA)图像中患侧及健侧大脑中动脉供血区域CT值方差比与大脑中动脉闭塞急性缺血性脑卒中(AIS-MCAO)代偿情况及短期预后相关性。方法选择CTA确诊的大脑中动脉闭塞急性缺血性脑卒中(AIS-MCAO)患者73例。根据患者90 d改良Rankin评分将患者分为预后良好组(42例)及预后不良组(31例)。应用Logistic回归分析影响AIS-MCAO患者预后的相关因素。应用ROC曲线检测CT值方差比在AIS-MCAO患者短期预后中的预测价值。结果患者患侧及健侧大脑中动脉供血区域CT值方差比是预后的独立危险因素(P<0.05)。CT值比值的ROC曲线下面积为0.887。在ROC曲线中HU值比值的约登指数为0.694,所对应的最佳临界点为0.675,当CT值比值<0.675时,患者预后不良的可能性大。结论患者患侧及健侧大脑中动脉供血区域CT值方差比可有效评估AIS-MCAO患者的短期预后。Objective To evaluate the short-term prognosis of patients with acute ischemic stroke with middle cerebral artery occlusion(AIS-MCAO)using the ratio of Hounsfield unit(HU)variance.Methods A total of 73 patients with AIS-MCAO confirmed using CTA were enrolled.According to the modified Rankin score(mRS)at 90 days,patients were divided into a good prognosis group(42 patients)and a poor prognosis group(31 patients).Logistic regression analysis was used to analyze the factors affecting the prognosis of patients with AIS-MCAO.A receiver operating characteristic(ROC)curve was used to determine the predictive value of rHUV for the short-term prognosis of patients with AIS-MCAO.Results The rHUV was independent risk factor for prognosis(P<0.05).The area under the ROC curve of the rHUV was 0.887.The Youden index of rHUV in the ROC curve was 0.694,with an optimal critical point of 0.675,indicating that rHUV<0.675 was associated with a poor prognosis,whereas rHUV>0.675 indicated a good prognosis.Conclusion We established a simple algorithm,rHUV,that could effectively evaluate the short-term prognosis of patients with AIS-MCAO.

关 键 词：计算机断层扫描血管造影 大脑中动脉闭塞性急性缺血性 脑卒中 ASPECTS评分 改良mRS评分 

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]