头颅CT灌注成像联合磁共振血管成像评估急性缺血性脑卒中患者预后的应用研究  

Application of Cranial CT Perfusion Imaging Combined with Magnetic Resonance Angiography in Evaluating the Prognosis of Acute Ischemic Stroke Patients

作　　者：唐清 费宗茹 董军 焦俊 张淼 戴晓梅 TANG Qing;FEI Zong-ru;DONG Jun;JIAO Jun;ZHANG Miao;DAI Xiao-mei(Department of Radiology,Liuhe District Traditional Chinese Medicine Hospital of Nanjing,Nanjing,Jiangsu,211500,China)

机构地区：[1]南京市六合区中医院放射科,江苏南京211500

出　　处：《现代生物医学进展》2025年第6期1057-1064,共8页Progress in Modern Biomedicine

基　　金：南京市医学科技发展项目(YKK13216)。

摘　　要：目的:探讨头颅电子计算机断层扫描灌注成像(CTP)联合磁共振血管成像(MRA)评估急性缺血性脑卒中(AIS)患者预后的应用效果。方法:选择从2022年1月到2024年4月在我院接受治疗的AIS患者85例作为观察对象。根据预后情况分为预后不良组和预后良好组,对比两组基线资料、头颅CTP参数、MRA指标及改良Rankin量表(mRS)评分。Pearson法分析头颅CTP参数、MRA指标与预后的相关性。受试者工作特征(ROC)曲线分析头颅CTP参数、MRA指标单独及联合检查预测AIS患者预后的效能。结果:预后不良组的年龄及美国国立卫生研究院卒中量表(NIHSS)评分高于预后良好组(P<0.05)。预后不良组的脑血流量(CBF)、脑血容量(CBV)水平低于预后良好组,平均通过时间(MTT)、达峰时间(TTP)、狭窄率及m RS评分高于预后良好组(P<0.05)。Pearson相关性分析显示,头颅CTP参数CBV、CBF与m RS评分呈负相关,MTT、TTP、狭窄率与mRS评分呈正相关(P<0.05)。CBV、CBF、MTT、TTP及狭窄率单独及联合检查预测AIS患者预后的曲线下面积(AUC)分别为0.533、0.612、0.604、0.729、0.735、0.977,五项指标联合检查对AIS患者预后的预测效能高于各项指标单独检查的预测效能。结论:头颅CTP参数(CBV、CBF、MTT及TTP)、MRA指标(狭窄率)检查能够有效预测AIS患者的预后,且联合检测的预测效果更佳。Objective:To explore the application effect of cranial computed tomography perfusion imag ing(CTP)combined with magnetic resonance angiography(MRA)in evaluating the prognosis of patients with acute ischemic stroke(AIS).Methods:85 AIS patients who received treatment in our hospital from January 2022 to April 2024 were selected as the observation subjects.The patients were divided into poor prognosis group and good prognosis group according to the prognosis,the baseline data,cranial CTP pa rameters,MRA indicators and modified rankin scale(mRS)scores were compared between the two groups.The correlation between cranial CTP parameters,MRA indicators and prognosis was analyzed by pearson correlation.The efficacy of cranial CTP parameters,MRA indicators alone and in combination in predicting the prognosis of AIS patients were analyzed by receiver operating characteristic(ROC)curve.Results:The age and national institutes of health stroke scale(NIHSS)score in the poor prognosis group were higher than those in the good prognosis group(P<0.05).The levels of cerebral blood flow(CBF)and cerebral blood volume(CBV)in the poor prognosis group were lower than those in the good prognosis group,while the mean transit time(MTT),time to peak(TTP),stenosis rate and mRS score were higher than those in the good prognosis group(P<0.05).Pearson correlation analysis showed that,the cranial CTP parameters such as CBV and CBF were negatively correlated with mRS score,while MTT,TTP and stenosis rate were positively correlated with mRS score(P<0.05).The area under the curve(AUC)for predicting the prognosis of AIS patients using CBV,CBF,MTT,TTP and stenosis rate alone and in combination were 0.533,0.612,0.604,0.729,0.735 and 0.977,respectively,the predictive power of the combined examination of these five indicators for the prognosis of AIS patients was higher than that of each indicator alone.Conclusion:Cranial CTP parameters(CBV,CBF,MTT and TTP)and MRA indicators(stenosis rate)can effectively predict the prognosis of AIS patients,and the comb

关 键 词：CT灌注成像 磁共振血管成像 急性缺血性脑卒中 预后 预测价值 

分 类 号：R3[医药卫生—基础医学] R743.3R816.1