MR-DTI序列联合CTP参数对急性脑梗死患者预后的评估价值  

Evaluative value of MR-DTI sequence combined with CTP parameters for prognosis in patients with acute cerebral infarction

作　　者：王坤 吴利忠 郑庆中 王盛智 WANG Kun;WU Lizhong;ZHENG Qingzhong;WANG Shengzhi(Hainan Western Central Hospital,Danzhou 571700,China)

机构地区：[1]海南西部中心医院,海南儋州571700

出　　处：《中国实用神经疾病杂志》2024年第8期951-955,共5页Chinese Journal of Practical Nervous Diseases

基　　金：海南省医药卫生科研项目(编号:20A200008)。

摘　　要：目的探讨磁共振扩散张量成像(MR-DTI)序列联合CT灌注成像(CTP)参数对急性脑梗死(ACI)患者预后的评估价值。方法选取海南西部中心医院2021-05—2023-05收治的106例ACI患者为研究对象,所有患者入院时均接受MR-DTI序列、CTP检查。阿替普酶静脉溶栓治疗后3个月评定预后情况,并据此将其分为预后良好组和预后不良组,对比不同预后患者MR-DTI序列、CTP参数,通过受试者工作特征(ROC)曲线探讨MR-DTI序列联合CTP参数评估ACI患者预后的价值。结果106例ACI患者中,预后良好86例(81.13%),预后不良20例(18.87%)。预后不良组Exat、MTT、TTP参数值显著高于预后良好组,FA、DCavg、CBF、CBV参数值显著低于预后良好组(P<0.05)。ROC曲线显示,Exat、FA、DCavg、CBF、CBV、MTT、TTP及上述指标联合评估ACI患者预后的曲线下面积(AUC)分别为0.704、0.743、0.692、0.707、0.654、0.660、0.660、0.901,Exat、FA、CBF、联合评估具有较好的价值,联合评估的价值最高,DCavg、CBV、MTT、TTP单独评估的价值较低。结论MR-DTI序列联合CTP参数可应用于ACI患者的预后评估中,且评估价值较高。Objective To investigate the evaluative value of magnetic resonance-diffusion tensor imaging(MR-DTI)sequence combined with computed tomography perfusion imaging(CTP)parameters in patients with acute cerebral infarction(ACI).Methods Totally 106 ACI patients admitted to the Hainan Western Central Hospital from May 2021 to May 2023 were selected as the study subjects.All patients underwent MR-DTI sequence and CTP examination upon admission.Patients were given intravenous thrombolysis with ateplase,and their prognosis was evaluated 3 months after treatment.Based on this,106 patients were divided into the good prognosis group and the poor prognosis group.The MR-DTI sequence and CTP parameters of ACI patients with different prognosis were compared,and the value of MR-DTI sequence combined with CTP parameters in evaluating the prognosis of ACI patients was investigated by receiver operating characteristic(ROC)curve.Results Of the 106 ACI patients,86(81.13%)had good prognosis,20 cases(18.87%)had poor prognosis.The parameters of Exat,MTT,and TTP in the poor prognosis group were significantly higher than those in the good prognosis group.The parameters of FA,DCavg,CBF,and CBV were significantly lower than those of the good prognosis group(P<0.05).ROC curve showed that the area under the curve(AUC)of Exat,FA,DCavg,CBF,CBV,MTT,TTP and the combination of the above indexes in evaluating the prognosis of ACI patients were 0.704,0.743,0.692,0.707,0.654,0.660,0.660 and 0.901,respectively.Exat,FA,CBF,combined evaluation had good value,and the value of combined evaluation was the highest.The value of DCavg,CBV,MTT and TTP alone was low.Conclusion The combination of MR-DTI sequence and CTP parameters can be applied to the prognosis evaluation for ACI patients,and the evaluation value is relatively high.

关 键 词：急性脑梗死 磁共振扩散张量成像 CT灌注成像 阿替普酶 静脉溶栓 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R445[医药卫生—临床医学]