CT血管造影与常规CT评估急性缺血性卒中评分的临床对比研究  

Evaluation of Acute Ischemic Stroke by CT Angiography and Non-contrast CT

作　　者：于晓丽[1] 刘奎[1] 杨扬 孟令新[2] YU Xiao-li;LIU Kui;YANG Yang;MENG Ling-xin(Department of Emergency Medicine,Qingdao Eighth People's Hospital,Qingdao 266100,Shandong Province,China;Department of Emergency Medicine,People's Hospital of Rizhao,Rizhao 266200,Shandong Province,China)

机构地区：[1]青岛市第八人民医院急诊医学部,山东青岛266100 [2]日照市人民医院急诊医学部,山东日照266200

出　　处：《中国CT和MRI杂志》2025年第1期13-15,共3页Chinese Journal of CT and MRI

摘　　要：目的 本研究旨在比较早期CT评分(Aspects)及使用CT血管成像(CTA)原始图像与非增强CT (NCCT)在区分不同时间窗内缺血核心体积≥70mL的梗塞范围方面的表现。方法 分析73例AIS-LVO患者的多模式CT表现。自动软件被用来计算方面区域。衰减变化定义为所有10个方面区域的相对Hounsfield单位(RHU)值与权重因子的乘积之和。各区域的Rh u值为缺血侧的H U值与对侧的HU值。由于Aspects模板中的每个区域在As pects系统中的权重不成比例,因此相应的权重因子是从多变量线性回归模型中得出的回归系数,该模型用于将区域RH U与缺血核心体积相关联。分别使用CTA和NCCT计算自动纵横比和衰减变化。结果在不同的时间窗内(Rho为0.439~0.637),衰减变化与缺血核心体积相关。以缺血核心≥为70mL,其衰减变化表现与Aspects(曲线下面积0.799~0.891)相近,与DeLong's检验(P=0.079,P=0.373)相近,CTA(AU C=0.842)与NCCT(AUC=0.838)无差异。结论Aspects区域的衰减变化与缺血核心体积相关。在脑梗塞体积的分类中,衰减变化具有与自动化方面相当的高诊断能力。复杂的评分算法不涉及衰减变化的测量。这种测量方法可以作为一种有效、快速、可靠、准确的手段来评估不同时间窗内的脑梗塞范围。通过衰减变化测量梗死体积以确定更适合再灌注治疗的患者的有用性可以在未来的临床试验中得到验证。Objective This study was designed to compare attenuation changes with automated Alberta Stroke program early CT scores(Aspects)and the use of CT angiography(CTA)raw images versus nonenhanced CT(NCCT)in differentiating infarcts with ischemic core volume≥70mL in different time Windows.Methods The multimodal CT findings of 73 AIS-LVO patients were analyzed.Automated software is used to calculate the area.The attenuation change is defined as the sum of the product of the relative Hounsfield unit(RHU)values and the weight factors for all 10 aspect regions.The Rhu values of each region were HU values of the ischemic side and HU values of the opposite side.Because each region in the Aspects template is disproportionately weighted in the Aspects system,the corresponding weighting factor is a regression coefficient derived from a multivariate linear regression model used to correlate regional RHU with ischemic core volume.Automatic aspect ratio and attenuation changes are calculated using CTA and NCCT,respectively.Results In different time Windows(Rho=0.439~0.637),attenuation was correlated with ischemic core volume.With ischemic core≥70mL,its attenuation changes were similar to Aspects(area under the curve 0.799~0.891)and similar to DeLong's test(P=0.079,P=0.373).There was no difference between CTA(AUC=0.842)and NCCT(AUC=0.838).Conclusion The attenuation in Aspects area is related to ischemic core volume.In the classification of infarct volume,attenuation variation has a high diagnostic capability comparable to that of automation.Complex scoring algorithms do not involve measurement of attenuation changes.This measurement method can be used as an effective,rapid,reliable and accurate means to evaluate the extent of cerebral infarction in different time Windows.The usefulness of measuring infa rct volume by attenuation change to identify patients more suitable for reperfusion thera py could be validated in future clinica trias.

关 键 词：CT血管造影 非对比CT 急性缺血性卒中 CT评分算法 

分 类 号：R814.43[医药卫生—影像医学与核医学]