双源CT全脑灌注成像预测急性缺血性脑卒中患者预后的临床价值  

Prognostic Value of Dual-source CT Whole-Brain Perfusion Imaging in Patients with Acute Ischemic Stroke

作　　者：张磊[1] 王建业 ZHANG Lei;WANG Jianye(Department of CT Imaging Diagnosis,Nanyang Central Hospital,Nanyang Henan 473000)

机构地区：[1]南阳市中心医院CT影像诊断科,河南南阳473000

出　　处：《医学临床研究》2025年第2期218-220,224,共4页Journal of Clinical Research

摘　　要：【目的】探讨双源CT全脑灌注成像(CTP)预测急性缺血性脑卒中(AIS)患者预后的临床价值。【方法】本院收治的100例AIS患者,根据患者出院第90天的改良Rankin预后等级量表(mRS)评分分为预后不良组(mRS评分>2分,n=31)及预后良好组(mRS评分≤2分,n=69),比较两组的基线mRS及美国国立卫生研究院卒中量表(NIHSS)评分,采用双源CTP检查计算患者的脑血容量(CBV)、达峰时间(TTP)、平均通过时间(MTT)、延迟时间(TD)。分析基线NIHSS评分及mRS评分与CBV、TTP、MTT及TD的相关性,分析上述参数对AIS患者90 d预后的影响。【结果】预后良好组与预后不良组患者的临床基本资料比较,差异均无统计学意义(P>0.05);与预后良好组患者相比,预后不良组患者CBV减少,但TTP、MTT及TD延长(P<0.05);Pearson相关性分析显示,mRS评分及NIHSS评分分别与CBV呈显著负相关,与TTP、MTT及TD呈显著正相关(P<0.05);多因素Logistic回归分析显示,CBV是影响AIS患者90 d内预后的独立保护因素,TTP是影响AIS患者90 d内预后的独立危险因素(P<0.05)。【结论】双源CTP相关参数是潜在的预后AIS患者90 d内预后的因素,其中CBV是影响预后的保护因素,而TTP是影响预后的危险因素,CBV、TTP、MTT及TD与基线mRS评分及NIHSS评分存在显著相关性,有助于早期识别高风险患者并指导个性化治疗。【Objective】To investigate the clinical value of dual-source CT whole brain perfusion imaging(CTP)in predicting the prognosis of patients with acute ischemic stroke(AIS).【Methods】A total of 100 patients with AIS admitted to our hospital were divided into poor prognosis group(mRS scores>2 points,n=31)and good prognosis group(mRS scores≤2 points,n=69)according to mRS Scores on the 90th day after discharge.Baseline mRS and National Institutes of Health Stroke Scale(NIHSS)scores of all patients were compared.Cerebral blood volume(CBV),time to peak(TTP),mean transit time(MTT),and time of delay(TD)were calculated by dual-source CTP.The correlation of baseline NIHSS score and mRS Score with CBV,TTP,MTT and TD was discussed,and the influence of these parameters on the 90d prognosis of AIS patients was analyzed.【Results】There was no statistical significance in the basic clinical data between the good prognosis group and the poor prognosis group(P>0.05).Compared with the good prognosis group,CBV was decreased in the poor prognosis group,but TTP,MTT and DLT were increased(P<0.05).Pearson correlation analysis showed that mRS and NIHSS scores were negatively correlated with CBV and positively correlated with TTP,MTT and TD,respectively(P<0.05).Multivariate Logistic regression showed that CBV was an independent protective factor affecting the prognosis of AIS patients within 90 days,and TTP was an independent risk factor affecting the prognosis of AIS patients within 90 days(P<0.05).【Conclusion】Dual-source CTP related parameters are potential prognostic factors in AIS patients within 90 days,in which CBV is a protective factor affecting prognosis,while TTP is a risk factor affecting prognosis.CBV,TTP,MTT and TD are significantly correlated with baseline mRS And NIHSS scores.Helps to identify high-risk patients early and guide personalized treatment.

关 键 词：脑缺血 卒中 急性病 体层摄影术 螺旋计算机 预后 

分 类 号：R743.3[医药卫生—神经病学与精神病学]