CT灌注成像中Mismatch比值和扩散加权成像评估急性缺血性脑卒中患者病灶转归  

Mismatch ratio in CT perfusion and diffusion weighted imaging to evaluate the lesion outcome of acute ischemic stroke patients

作　　者：谢艳君 陈德全 彭菁 游兴攀 蔡渝 官彬[1] 喻媛 杨理丹 XIE Yanjun;CHEN Dequan;PENG Jing;YOU Xingpan;CAI Yu;GUAN Bin;YU Yuan;YANG Lidan(Department of Radiology,the People’s Hospital of Chongqing Hechuan District,Chongqing 401520,China)

机构地区：[1]重庆市合川区人民医院放射科,重庆401520

出　　处：《实用放射学杂志》2024年第7期1043-1047,共5页Journal of Practical Radiology

基　　金：重庆市合川区科技局科技计划项目(hckj2022-54)。

摘　　要：目的探讨CT灌注成像(CTP)中不匹配区(Mismatch)比值和扩散加权成像(DWI)评估急性缺血性脑卒中(AIS)患者治疗后病灶转归的影响因素。方法回顾性分析AIS患者Mismatch比值>1.2组与Mismatch比值≤1.2组间、出血转化组和无出血转化组间临床及影像资料有无差异。结果AIS患者Mismatch比值>1.2组发病年龄及美国国立卫生研究院卒中量表(NIHSS)评分大于Mismatch比值≤1.2组,前者高血脂及新梗死灶发生率均低于后者,而高凝、脑出血及大面积脑梗死发生率均高于后者。出血转化组中NIHSS评分高于无出血转化组,前者大面积脑梗死及数字减影血管造影(DSA)取栓发生率均高于后者。多因素logistic分析显示年龄、NIHSS评分、高血脂是AIS患者Mismatch比值>1.2的独立危险因素,大面积脑梗死是出血转化的独立危险因素。结论CTP中Mismatch比值与AIS患者年龄、NIHSS评分、高血脂相关,大面积脑梗死与出血转化相关。Objective To investigate the influencing factors of Mismatch ratio in computed tomography perfusion(CTP)and diffusion weighted imaging(DWI)to assess the lesion outcome after treatment in patients with acute ischemic stroke(AIS).Methods Whether there were any differences in clinical and imaging data of AIS patients were analyzed retrospectively between the Mismatch ratio>1.2 group and the Mismatch ratio≤1.2 group,and between the hemorrhagic transformation group and the non-hemorrhagic transformation group.Results The age of onset and National Institutes of Health Stroke Scale(NIHSS)score of AIS patients in the group with Mismatch ratio>1.2 were greater than those in the group with Mismatch ratio≤1.2.The Mismatch ratio>1.2 group had lower incidence of hyperlipidemia,new infarct foci,and higher hypercoagulability,cerebral hemorrhage,as well as large cerebral infarction.The NIHSS score was higher in the hemorrhagic transformation group than the non-hemorrhagic transformation group,and the incidence of large cerebral infarction and digital subtraction angiography(DSA)thrombectomy was higher in the former than in the latter.Multifactorial logistic analysis showed that age,NIHSS score,and hyperlipidemia were independent risk factors for AIS patients with Mismatch ratio>1.2 and large cerebral infarction was an independent risk factor for hemorrhagic transformation.Conclusion The Mismatch ratio in CTP is correlated with age,NIHSS score,and hyperlipidemia in patients with AIS and large cerebral infarction is correlated with hemorrhagic transformation.

关 键 词：急性缺血性脑卒中 CT灌注成像 扩散加权成像 出血转化 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R814.43[医药卫生—临床医学] R445.2