弥散张量成像联合血清Hcy对缺血性卒中合并颈动脉斑块患者的诊断价值分析  

Diagnostic value of diffusion tensor imaging combined with serum Hcy in patients with ischemic stroke complicated with carotid plaque

作　　者：周骞 夏春华[1] 陈兵[1] Qian Zhou;Chunhua Xia;Bing Chen(Imaging Center,Hefei First People's Hospital(the Third Affiliated Hospital of Anhui Medical University),Hefei 230601,China)

机构地区：[1]合肥市第一人民医院(安徽医科大学第三附属医院)影像中心,合肥230601

出　　处：《中华神经创伤外科电子杂志》2024年第6期367-372,共6页Chinese Journal Of Neurotraumatic Surgery:Electronic Edition

摘　　要：目的探讨弥散张量成像联合血清同型半胱氨酸(Hcy)对缺血性卒中合并颈动脉斑块的诊断价值。方法回顾性选取合肥市第一人民医院影像中心自2021年1月至2022年6月收治的142例缺血性卒中患者为研究对象,根据是否有颈动脉斑块分为颈动脉斑块组和无颈动脉斑块组。采用MRI扫描仪对患者进行弥散张量成像(DTI)检查,采用酶循环法检测Hcy水平,采用受试者工作特征(ROC)曲线分析弥散张量成像参数[各向异性分数(FA)及平均弥散率(MD)]与Hcy水平对缺血性卒中合并颈动脉斑块的诊断效能。结果142例缺血性卒中患者中,无颈动脉斑块组75例,颈动脉斑块组67例。与无颈动脉斑块组相比,颈动脉斑块组患者的DTI参数中FA和MD表达均降低,血清中Hcy水平升高,差异有统计学意义(P<0.05)。Logistic回归分析显示,FA、MD和Hcy均是缺血性卒中合并颈动脉斑块的危险因素(P<0.05)。ROC曲线分析显示,FA、MD和Hcy对脑卒中合并颈动脉斑块诊断的曲线下面积(AUC)分别为0.830、0.820、0.841,将FA、MD和Hcy联合检测的AUC为0.909,高于FA、MD及Hcy的单项检测。结论DTI参数联合Hcy检测可提高缺血性卒中合并颈动脉斑块的诊断效能。Objective To investigate the diagnostic value of diffusion tensor imaging combined with homocysteine(Hcy)in patients with ischemic stroke complicated with carotid plaque.Methods A total of 142 patients with ischemic stroke admitted to Imaging Center of Hefei First People&apos;s Hospital from January 2021 to June 2022 were retrospectively selected as the study objects,and were divided into carotid plaque group and no carotid plaque group according to whether they had carotid plaque.The patients were examined by diffusion tensor imaging(DTI)using MRI scanner,the homocysteine level was detected by enzyme circulation method,and the diagnostic efficacy of diffusion tensor imaging parameters[fractional anisotropy(FA)and mean diffusivity(MD)]and Hcy levels for ischemic stroke complicated with carotid plaques was analyzed by receiver operating characteristic(ROC)curve.Results Among 142 patients with ischemic stroke,there were 75 cases in no carotid plaque group and 67 cases carotid plaque group.Compared with no carotid plaque group,the DTI parameters of FA and MD in patients with carotid plaques were reduced,and the serum Hcy level was increased,with statistical significance(P<0.05).Logistic regression analysis showed that FA,MD,and Hcy were all risk factors for ischemic stroke complicated with carotid plaques(P<0.05).ROC curve analysis showed that the area under the curve(AUC)of FA,MD,and Hcy for the diagnosis of stroke complicated with carotid plaques were 0.830,0.820,and 0.841,respectively.The AUC of the combined detection of FA,MD,and Hcy was 0.909,which was higher than the single detection of FA,MD,and Hcy.Conclusion Magnetic resonance diffusion imaging DTI parameters combined with Hcy testing can improve the diagnostic efficiency of patients with ischemic stroke complicated with carotid plaque.

关 键 词：缺血性卒中 颈动脉斑块 弥散张量成像 同型半胱氨酸 

分 类 号：R743.3[医药卫生—神经病学与精神病学]