脑CT灌注成像在急性脑梗死颅内大血管闭塞治疗中的预测价值  

Prognostic Value of Cerebral CT Perfusion Imaging in the Treatment of Intracranial Large Vessel Occlusion in Acute Cerebral Infarction

作　　者：周田 王丽[1] ZHOU Tian;WANG Li(Department of Brain Imaging,Liaocheng People's Hospital,Liaocheng Shandong 252000,China)

机构地区：[1]聊城市人民医院脑科影像科,山东聊城252000

出　　处：《中国卫生标准管理》2024年第14期101-105,共5页China Health Standard Management

摘　　要：目的探讨对急性脑梗死颅内大血管闭塞患者进行脑CT灌注成像参数在患者治疗后的预测价值。方法选取2020年9月—2022年9月聊城市人民医院收治的90例急性脑梗死颅内大血管闭塞患者作为研究对象。经治疗后分为预后良好组62例,预后不良组28例。均行脑CT灌注成像参数,比较脑CT灌注成像参数、绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析。结果急性脑梗死颅内大血管闭塞患者脑梗死区脑血容量(cerebral blood volume,CBV)为(3.01±0.82)mL/(min·100g)、脑血流量(cerebral blood flow,CBF)为(43.57±10.35)mL/(min·100 g),低于脑健侧区的(5.69±1.23)mL/(min·100g)、(85.36±18.24)mL/(min·100g),差异有统计学意义(P<0.05);脑梗死区平均通过时间(mean transit time,MTT)为(6.12±1.34)s、达峰时间(time to peak,TTP)为(18.62±2.21)s,长于脑健侧区的(2.59±1.32)s、(7.24±1.32)s,差异有统计学意义(P<0.05);预后不良组CBV为(2.35±0.24)mL/(min·100 g)、CBF为(21.35±4.52)mL/(min·100g),低于预后良好组的(3.12±0.21)mL/(min·100 g)、(47.26±5.26)mL/(min·100 g),差异有统计学意义(P<0.05);预后不良组MTT为(6.53±2.41)s、TTP为(24.53±4.62)s、长于预后良好组的(4.13±1.52)s、(9.34±1.82)s,差异有统计学意义(P<0.05);ROC曲线中CBV参数诊断敏感度最高,为96.40%,MTT参数特异度最高,为77.40%。结论脑CT灌注成像指标可作为评估脑梗死患者预后的重要指标,其中CBV指标对评估脑梗死患者预后具有较高的敏感性和特异性,结合其他影像学指标对评估脑梗死患者预后具有重要意义。此文的研究结果为急性脑梗死颅内大血管闭塞预后后期标准制定提供了借鉴内容。Objective To investigate the predictive value of cerebral CT perfusion imaging parameters in patients with acute cerebral infarction with intracranial large vessel occlusion after treatment.Methods A total of 90 patients with intracranial large vessel occlusion with acute cerebral infarction admitted to Liaocheng People's Hospital from September 2020 to September 2022 were selected as the study objects.After treatment,the patients were divided into good prognosis group(62 cases)and bad prognosis group(28 cases).All performed brain CT perfusion imaging parameters,compared brain CT perfusion imaging parameters and drew receiver operating characteristic(ROC)curves.Results In patients with acute cerebral infarction,the cerebral blood volume(CBV)and cerebral blood flow(CBF)of cerebral infarction area were(3.01±0.82)mL/(min·100 g)and(43.57±10.35)mL/(min·100 g)respectively,which was lower than(5.69±1.23)mL/(min·100 g)and(85.36±18.24)mL/(min·100 g)of the healthy side of brain,and the difference was statistically significant(P<0.05).Mean transit time(MTT)and time to peak(TTP)in cerebral infarction area were(6.12±1.34)s and(18.62±2.21)s,which were longer than(2.59±1.32)s and(7.24±1.32)s in the healthy side of brain,and the difference was statistically significant(P<0.05).In the bad prognosis group,the CBV was(2.35±0.24)mL/(min·100 g)and the CBF was(21.35±4.52)mL/(min·100 g),which was lower than(3.12±0.21)mL/(min·100 g)and(47.26±5.26)mL/(min·100 g)in the good prognosis group,and the difference was statistically significant(P<0.05).MTT and TTP of thebad prognosis group were(6.53±2.41)s and(24.53±4.62)s,which were longer than(4.13±1.52)s and(9.34±1.82)s of the good prognosis group,and the difference was statistically significant(P<0.05).In ROC curve,the diagnostic sensitivity of CBV parameter was the highest(96.40%),and the specificity of MTT parameter was the highest(77.40%).Conclusion Brain CT perfusion imaging index can be used as an important index to assess the prognosis of patients with cerebral

关 键 词：脑CT 灌注成像参数 急性脑梗死 颅内大血管闭塞 预后 预测价值 

分 类 号：R743[医药卫生—神经病学与精神病学]