CT灌注成像联合MRA对缺血性脑卒中的诊断价值  

Clinical Application Value of CT Perfusion Imaging Combined with MRA in the Diagnosis of Ischemic Stroke

作　　者：花纯香 蔡冬梅 居敏昊 姜亦伦 HUA Chunxiang;CAI Dongmei;JU Minhao;JIANG Yilun(Department of Imaging,Xishan People’s Hospital of Wuxi,Jiangsu 214000,China)

机构地区：[1]无锡市锡山人民医院影像科,江苏214000

出　　处：《影像科学与光化学》2025年第2期128-133,共6页Imaging Science and Photochemistry

摘　　要：目的:探讨CT灌注成像(CTP)联合磁共振血管成像(MRA)在缺血性脑卒中(CIS)诊断中的应用价值。方法:回顾性选取2018年3月至2024年3月于本院就诊的疑似CIS患者202例为研究对象,以数字减影血管造影(DSA)检查结果为金标准,分为CIS组(135例)和对照组(67例)。所有患者均接受CTP和MRA检查,计算MRA与DSA诊断的一致性(Kappa值),比较两组CTP参数差异,采用多因素逻辑回归分析探索CIS风险因素,并通过ROC曲线分析CTP参数、MRA及其联合诊断对CIS的价值。结果:一致性Kappa值为0.61(P<0.001),一致性中等。2组一般资料比较差异无统计学意义(P>0.05);CIS组患者CBF低于对照组,MTT、TTP高于对照组,差异有统计学意义(P<0.05)。联合诊断的AUC为0.987(95%CI:0.954~0.998),灵敏度为93.14%,特异度为96.08%(P<0.001)。结论:CTP参数联合MRA在CIS诊断中具有较高的应用价值,为临床提供了重要参考。Objective:To explore the clinical application value of CT perfusion imaging(CTP)combined with magnetic resonance angiography(MRA)in the diagnosis of ischemic stroke(CIS).Methods:A retrospective study was conducted on 202 suspected CIS patients admitted to our hospital from March 2018 to March 2024.Patients were divided into CIS group(n=135)and control group(n=67)based on digital subtraction angiography(DSA)results.All patients underwent CTP and MRA examinations.We calculated the Kappa value to assess the consistency between MRA and DSA diagnoses,compared differences in CTP parameters between groups,used multivariate Logistic regression analysis to identify CIS risk factors,and evaluated the diagnostic value of CTP parameters,MRA,and their combination using ROC curve analysis.Results:The consistency Kappa value was 0.61(P<0.001),and the consistency was moderate.There was no significant difference in general data between the two groups(P>0.05).The CBF of the CIS group was lower than that of the control group,and the MTT and TTP were higher than those of the control group,and the difference was statistically significant(P<0.05).The AUC of the combined diagnosis was 0.987(95%CI:0.954⁃0.998),the sensitivity was 93.14%,and the specificity was 96.08%(P<0.001).Conclusion:CTP parameters combined with MRA have high application value in the diagnosis of CIS and provide an important reference for clinical practice.

关 键 词：CT灌注成像 磁共振血管成像 缺血性脑卒中 临床应用 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R814.43[医药卫生—临床医学] R445.2R816.1