基于血流灌注和代谢状态的MRI和CT检查在老年脑血管病评估中的效能分析  

Efficacy analysis of MRI and CT examinations based on blood perfusion and metabolic status in the assessment of cerebrovascular disease of the elderly

作　　者：吴晗 胡利芳 Wu Han;Hu Lifang(Department of Geriatric Medicine,Shandong Electric Power Center Hospital,Jinan 250002,China)

机构地区：[1]山东电力中心医院老年医学科,济南250002

出　　处：《中国医学装备》2024年第12期72-77,共6页China Medical Equipment

基　　金：山东省医药卫生科技发展计划([2020]491)。

摘　　要：目的:探讨基于血流灌注和代谢状态的磁共振成像(MRI)和X射线计算机断层扫描(CT)检查在老年脑血管病评估中的效能。方法:选取2021年3月至2023年3月山东电力中心医院收治的92例疑似老年脑血管病患者,所有患者均采用基于血流灌注和代谢状态的MRI和CT两种检查方法,检测脑血流量(CBF)、脑血容量(CBV)、达峰时间(TTP)和平均通过时间(MTT),采用正电子发射计算机断层显像/CT(PET/CT)扫描检测葡萄糖代谢率(CMRGluc)、脑氧代谢率(CMRO_(2))和氧摄取分数(OEF)。采用四格表分析两种检查方法诊断老年脑血管病的效能。结果:所有患者双侧脑血流的轴向灌注在CT和MRI图像中均显示减少,但是CT显示患侧CBF、CBV降低幅度更大,患侧TTP、MTT增加幅度更大,与MRI检查患侧比较,差异有统计学意义(t=26.485、15.404、1.599、3.341,P<0.05),CT和MRI检查显示患侧脑代谢率参数均下降,但CT显示患侧CMRGluc、CMRO_(2)和OEF下降幅度更大,差异有统计学意义(t=3.390、2.710、2.996,P<0.05);CT和MRI检查诊断老年脑血管病的真阳性例数分别为88和80例,真阴性例数分别为2和1例,假阳性例数分别为1和4例,假阴性例数分别为1例、5例,CT诊断准确率与MRI检查比较差异无统计学意义(P>0.05)。结论:基于血流灌注和代谢状态的MRI在检测脑部的细微结构和功能方面具有较高的灵敏度,但对血管的显示尚不如CT清晰。对于老年脑血管病还需CT和MRI的检查结果来做出更准确的诊断。Objective:To explore the efficacy of magnetic resonance imaging(MRI)and X-ray computed tomography(CT)examinations based on blood perfusion and metabolic status in the assessment of cerebrovascular disease of the elderly.Methods:A total of 92 elderly patients with suspected cerebrovascular disease admitted to Shandong Electric Power Center Hospital from March 2021 to March 2023 were selected.All patients were examined by using MRI and CT based on blood flow perfusion and metabolic status in order to detect cerebral blood flow(CBF),cerebral blood volume(CBV),time to peak(TTP),mean transit time(MTT),as well as glucose metabolism rate(CMRGluc),cerebral oxygen metabolism rate(CMRO2),and oxygen extraction fraction(OEF).Using a four grid table to analyze the efficacy of two examination methods in diagnosing cerebrovascular disease of elderly.Results:Both the perfusion CT and MRI images of cerebral blood flow on axial direction showed reduction,however,the CT showed a greater reduction in CBF and CBV on the affected side,and a greater increase in TTP and MTT on the affected side,and the differences of these indicators on the affected side between CT and MRI were significant(t=26.485,15.404,1.599,3.341,P<0.05),respectively.Both CT and MRI showed cerebral metabolic rate parameters on the affected side decreased,however,CT showed a greater decrease in CMRGluc,CMRO2 and OEF on the affected side,and the differences were statistically significant(t=3.390,2.710,2.996,P<0.05),respectively.The numbers of cases with true positive of CT and MRI were respectively 88 cases and 80 cases in diagnosing cerebrovascular disease of elderly,and the numbers of cases with true negative of them were respectively 2 cases and 1 case.The numbers of cases with false positive of them were respectively 1 case and 4 cases,and the numbers of cases with false negative were respectively 1 case and 5 cases.There was no significant difference in the diagnostic accuracy between CT examination and MRI examination(P>0.05).Conclusion:MRI has a higher sensitiv

关 键 词：血流灌注 代谢状态 磁共振成像(MRI) X射线计算机断层扫描(CT) 老年脑血管病 

分 类 号：R445.2[医药卫生—影像医学与核医学] R816.1[医药卫生—诊断学]