三种后处理软件在急性缺血性脑卒中CT灌注中的应用价值  

Application value of three postprocessing software in CT perfusion for acute ischemic stroke

作　　者：郭敏 谯秀逢 冯冬梅[1] 麻秋琎 尹家瑜 GUO Min;QIAO Xiu-feng;FENG Dong-mei;MA Qiu-jin;YIN Jia-yu(Department of Radiography,the First People’s Hospital of Nanning,Nanning 530012,Guangxi,CHINA)

机构地区：[1]南宁市第一人民医院放射科,广西南宁530012

出　　处：《海南医学》2025年第6期827-831,共5页Hainan Medical Journal

基　　金：广西壮族自治区卫生健康委员会计划项目(编号:Z-A20221079)。

摘　　要：目的分析ADW4.7、快速处理缺血性中风软件(F-STROKE)和数坤脑灌注CT图像处理软件计算急性缺血性脑卒中梗死核心体积、缺血体积、不匹配体积及不匹配率的一致性,并评估NIHSS评分和三种软件CTP参数对出血转化的预测价值。方法回顾分析2021年1月至2023年2月南宁市第一人民医院收治且行CTP检查的56例急性脑梗死患者的临床和影像资料,采用组内相关系数(ICC)比较ADW4.7、F-STROKE以及数坤脑灌注CT图像处理软件测量梗死核心体积、缺血体积、不匹配体积及不匹配率的一致性;根据1周后复查头颅CT平扫有无脑出血分为出血转化组14例,无出血转化组42例,采用偏相关分析NIHSS评分、CTP参数与出血转化的相关性;采用受试者工作特征(ROC)曲线及曲线下面积(AUC)分析NIHSS评分、CTP参数对出血转化的预测价值。结果三种软件在测量梗死体积及缺血体积结果上具有一致性,且F-STROKE和数坤测量缺血体积一致性最好(ICC=0.924);偏相关分析结果显示NIHSS评分、ADW4.7不匹配率与出血转化相关(P<0.05);ROC曲线结果分析显示,NIHSS评分、ADW4.7不匹配率及联合预测出血转化ROC曲线下面积(AUC)分别为0.669(95%CI:0.468~0.869)、0.767(95%CI:0.580~0.954)及0.746(95%CI:0.539~0.953),差异无统计学意义(P>0.05)。结论ADW4.7、F-STROKE及数坤三种后处理软件测量急性缺血性脑卒中CTP的梗死体积及缺血体积结果上具有较好的一致性。ADW4.7中不匹配率对急性缺血性脑卒中出血转化具有较高的诊断效能,能快速为下一步治疗提供精准的诊断依据。Objective To analyze the consistency of ADW4.7,F-STROKE,and Shukun Cerebral Perfusion CT Image Processing Software in calculating infarct core volume,ischemic volume,mismatch volume,and mismatch ratio in acute ischemic stroke(AIS),and to evaluate the predictive value of NIHSS scores and CTP parameters from the three software for hemorrhagic transformation(HT).Methods Clinical and imaging data of 56 AIS patients admitted to the First People’s Hospital of Nanning from January 2021 to February 2023 who underwent CTP were retrospectively analyzed.Intraclass correlation coefficient(ICC)was used to compare the consistency of ADW4.7,F-STROKE,and Shukun software in measuring infarct core volume,ischemic volume,mismatch volume,and mismatch ratio.Patients were divided into HT group(14 cases)and non-HT group(42 cases)based on the presence of cerebral hemorrhage on follow-up CT scans one week later.Partial correlation analysis was performed to assess the correlation between NIHSS scores,CTP parameters,and HT.Receiver operating characteristic(ROC)curves and area under the curve(AUC)were used to evaluate the predictive value of NIHSS scores and CTP parameters for HT.Results The three software showed good consistency in measuring infarct volume and ischemic volume,with the highest agreement between F-STROKE and Shukun in ischemic volume measurement(ICC=0.924).Partial correlation analysis revealed that NIHSS scores and ADW4.7 mismatch ratio were associated with HT(P<0.05).ROC curve analysis showed AUC values for NIHSS score,ADW4.7 mismatch ratio,and their combined prediction of HT were 0.669(95%CI:0.468-0.869),0.767(95%CI:0.580-0.954),and 0.746(95%CI:0.539-0.953),respectively,with no statistically significant differences(P>0.05).Conclusion ADW4.7,F-STROKE,and Shukun software demonstrate strong consistency in measuring infarct volume and ischemic volume in AIS CTP.The mismatch ratio from ADW4.7 has high diagnostic efficacy for predicting HT in AIS,providing rapid and precise guidance for clinical decision-making.

关 键 词：急性缺血性脑卒中 CT脑灌注 人工智能 出血转化 

分 类 号：R743.3[医药卫生—神经病学与精神病学]