全脑CT灌注成像应用于脑梗死患者大脑中动脉狭窄程度评估中的效果分析  

Effect of Whole Brain CT Perfusion Imaging on the Evaluation of Middle Cerebral Artery Stenosis in Patients with Cerebral Infarction

作　　者：刘春苗 耿立杰 刘文 LIU Chunmiao;GENG Lijie;LIU Wen(Department of Imaging,Jining Third People's Hospital,Jining 272100,Shandong,China)

机构地区：[1]济宁市第三人民医院影像科,山东济宁272100

出　　处：《世界复合医学(中英文)》2025年第3期153-157,共5页World Journal of Complex Medicine

摘　　要：目的 探讨全脑CT灌注成像参数评估脑梗死患者大脑中动脉(middle cerebral artery,MCA)狭窄程度的价值。方法 选取2022年1月—2024年1月在济宁市第三人民医院接受全脑CT灌注成像检查的60例脑梗死患者,并选取60名健康体检者作为参照,设为正常组,所有患者均接受CT血管造影(computed tomography angiography,CTA)检查评估MCA狭窄程度情况,比较不同MCA狭窄程度脑梗死患者的全脑CT灌注成像参数,重点分析全脑CT灌注成像参数评估脑梗死患者MCA狭窄程度的价值。结果 60例脑梗死患者经CTA检查发现MCA轻度狭窄18例,占比30.00%(18/60);中重度狭窄26例,占比43.33%(26/60);完全闭塞16例,占比26.67%(16/60)。完全闭塞组达峰时间(time to peak,TTP)、平均通过时间(mean transite time,MTT)及延迟时间(delay time,DLY)分别为(18.73±1.67)s、(6.79±1.02)s、(2.74±0.36)s,均高于中重度狭窄组的(17.02±1.70)s、(5.87±0.79)s、(2.41±0.33)s,轻度狭窄组的(15.55±1.66)s、(5.05±0.76)s、(2.10±0.30)s,正常组的(14.36±1.18)s、(4.06±0.60)s、(1.30±0.38)s;完全闭塞组的脑血容量(cerebral blood volume,CBV)为(29.73±4.16)mL/100 g,均低于中重度狭窄组的(42.37±7.10)mL/100 g、轻度狭窄组的(51.32±5.05)mL/100 g、正常组的(65.62±6.87)mL/100 g,差异均有统计学意义(F=15.172、17.815、15.963、57.922,P均<0.05)。受试者操作特征曲线结果显示,全脑CT灌注成像取得的TTP、CBV、MTT、DLY评估脑梗死患者MCA狭窄程度的曲线下面积均>0.70,且以联合评估价值最佳。结论 全脑CT灌注成像参数评估脑梗死MCA狭窄程度有较高的灵敏度及特异度,诊断价值较高。Objective To explore the value of whole brain CT perfusion imaging parameters in evaluating the degree of middle cerebral artery(MCA) stenosis in patients with cerebral infarction.Methods Sixty patients with cerebral infarction who underwent whole brain CT perfusion imaging in the Jining Third People's Hospital from January 2022 to January 2024 were selected,and 60 healthy subjects were selected as the normal group.All patients underwent computed tomography angiography(CTA) to evaluate the degree of MCA stenosis.The whole brain CT perfusion imaging parameters of patients with cerebral infarction with different degrees of MCA stenosis were compared,and the value of whole brain CT perfusion imaging parameters in evaluating the degree of MCA stenosis in patients with cerebral infarction was analyzed.Results Among 60 patients with cerebral infarction,18 cases of MCA mild stenosis were found by CTA examination,accounting for 30.00%(18/60);there were 26 cases of moderate to severe stenosis,accounting for 43.33%(26/60);there were 16 cases of complete occlusion,accounting for 26.67%(16/60).The time to peak(TTP),mean transit time(MTT) and delay time(DLY)in complete occlusion group were(18.73±1.67) s,(6.79±1.02) s and(2.74±0.36) s,respectively,which were higher than those in moderate to severe stenosis group(17.02±1.70) s,(5.87±0.79) s and(2.41±0.33) s,mild stenosis group(15.55±1.66) s,(5.05±0.76) s,(2.10±0.30) s,normal group(14.36±1.18) s,(4.06±0.60) s,(1.30±0.38) s;the cerebral blood volume(CBV) in the complete occlusion group was(29.73±4.16) mL/100 g,which was lower than(42.37±7.10) mL/100 g in the moderate to severe stenosis group,(51.32±5.05) mL/100 g in the mild stenosis group and(65.62±6.87) mL/100 g of normal group,and the differences were statistically significant(F=15.172,17.815,15.963,57.922,all P<0.05).The results of receiver operating characteristic curve showed that the areas under the curve of TTP,CBV,MTT,and DLY obtained by whole brain CT perfusion imaging to evaluate the degree of MCA steno

关 键 词：脑梗死 全脑CT灌注成像 大脑中动脉 狭窄程度 评估价值 

分 类 号：R743.3[医药卫生—神经病学与精神病学]