CTP成像参数在评估重度颈动脉狭窄患者保守治疗反应性中的应用价值研究  

The Application Value of CTP Imaging Parameters in Evaluating the Reactivity of Conservative Treatment in Patients with Severe Carotid Artery Stenosis

作　　者：王贺新[1] 张婷婷[3] 曹红举 刘中文 杨晓云 李红涛[2] WANG He-xin;ZHANG Ting-ting;CAO Hong-ju;LIU Zhong-wen;YANG Xiao-yun;LI Hong-tao(Department of Medical Imaging,Tianjin Armed Police Corps Hospital,Tianjin 300162,China;Department of Internal Medicine,Tianjin Armed Police Corps Hospital,Tianjin 300162,China;Military Preventive Medicine Teaching and Research Department,Department of HealthServices,Logistics University of People's Armed Police Force,Tianjin 300309,China;Department of Medical Imaging,Medical Center of Chinese Armed Police,Tianjin 300162,China)

机构地区：[1]武警天津总队医院医学影像科,天津300162 [2]武警天津总队医院内二科,天津300162 [3]武警后勤学院卫生勤务系军事预防医学教研室,天津300309 [4]武警特色医学中心医学影像科,天津300162

出　　处：《中国CT和MRI杂志》2024年第9期44-46,共3页Chinese Journal of CT and MRI

基　　金：天津市卫生健康委科研项目(2023GD-1069)。

摘　　要：目的探讨在检测重度颈动脉狭窄(CAS)患者保守治疗反应性中CT灌注成像(CTPI)参数的评估价值。方法选取于本院收治于2019年3月至2023年7月接受保守治疗的重度颈动脉狭窄患者193例,按照随访期内是否发生脑缺血性疾病分为高反应组(n=106)和低反应组(n=87)。比较各组患者CTP成像参数rMTT、rTTP、rCBV、rCBF,“金标准”为病理诊断结果,对保守治疗CAS患者发生脑缺血性疾病的影响因素进行多因素Logistic回归分析,并分析检测保守治疗重度CAS患者发生脑缺血性疾病中应用CTP成像参数的诊断价值。结果两组患者年龄、性别、高血脂及冠心病合并情况、吸烟史情况无显著差异(P>0.05),与高反应组相比,低反应组患者的高血压、糖尿病合并比例、rMTT、rTTP明显较高(P<0.05),rCBV、rCBF明显较低(P<0.05)。有高血压、糖尿病合并情况、低rMTT、rTTP、高rCBV、rCBF是脑缺血性疾病发生的危险因素(P<0.05)。CTP成像参数rMTT、rTTP、rCBV、rCBF联合检测重度颈动脉狭窄患者保守治疗反应性的灵敏度和准确度均高于四者独立检查(P<0.05)。结论在评估重度颈动脉狭窄患者保守治疗反应性中应用CTP成像参数的评估价值较高,值得临床推广。Objective To evaluate the value of CT perfusion imaging(CTPI)factor for measuring conservative treatment response in patients with severe carotid artery stenosis(CAS).Methods 193 patients with severe carotid artery stenosis who received conservative treatment from March 2019 to July 2023 were selected and classified into high-risk group(n=106)and low-response group(n=87)according to whether ischemic brain disease occurred or not.The CTP imaging parameters rMTT,rTTP,rCBV and rCBF of each group were compared,and the pathological diagnosis results were taken as the standard.Multifactor logistic regression analysis was conducted on the influencing factors of the occurrence of cerebral ischemic disease in CAS patients undergoing conservative treatment.Also for conservative treatment in patients with severe ioc in ischemic brain CTP imaging diagnosis of factor analysis and measuring value.Results Age,gender,hyperlipidemia,complications of coronary atherosclerosis,smoking history,etc.had no obvious difference between the two groups(P>0.05),however,hypertension,diabetes complications,rMTT,rTTP were significantly higher than those in the hyperresponsive group(P<0.05),and rCBV,rCBF were significantly lower(P<0.05).With hypertension,diabetic complications,low rMTT,rTTP,high rCBV and rCBF were risk factors for the development of ischemic cerebral diseases(P<0.05).Screening of conservative treatment responses in patients with severe carotid angina with CTP imaging parameters rMTT,rTTP,rCBV and rCBF were more sensitive and accurate than those 4 individual tests(P<0.05).Conclusion The application of CTPI parameters in evaluating conservative treatment responsiveness in patients with severe carotid artery stenosis is worthy of widespread dissemination clinically.

关 键 词：颈动脉狭窄 CTP成像 参数 保守治疗 反应性 价值 

分 类 号：R543.5[医药卫生—心血管疾病]