脑CT灌注成像结合头颈部CT血管成像在急性缺血性脑卒中诊断中的价值  

Value of Brain CT Perfusion Imaging Combined with Head and Neck CT Angiography in the Diagnosis of Acute Ischemic Stroke

作　　者：魏爱梅 王丽芳 王瑞丽 WEI Aimei;WANG Lifang;WANG Ruili(Department of Imaging,Caoxian County Hospital,Heze 274400,Shandong,China)

机构地区：[1]山东省菏泽市曹县县立医院影像科,山东菏泽274400

出　　处：《世界复合医学(中英文)》2025年第3期158-161,共4页World Journal of Complex Medicine

摘　　要：目的 分析脑CT灌注成像(computed tomography perfusion,CTP)结合头颈部CT血管成像(computed tomography angiography,CTA)对急性缺血性脑卒中的诊断价值。方法 选取2022年9月—2023年6月山东省菏泽市曹县县立医院选取的76名疑似急性缺血性脑卒中患者为研究对象,均行脑CTP、头颈部CTA检查,以数字减影血管造影(digital subtraction angiography,DSA)检查结果为金标准,分析3种检查方式的诊断结果及诊断效能。结果 76例急性缺血性脑卒中患者中,DSA检出阳性64例,阴性12例;头颈部CTA检出阳性55例,阴性21例;脑CTP检出阳性54例,阴性22例;脑CTP联合头颈部CTA检出阳性62例,阴性14例。单一头颈部CTA、脑CTP及联合检查的特异度、阳性预测值比较,差异均无统计学意义(P均>0.05)。联合检查的灵敏度为93.75%(60/64)、准确度为92.11%(70/76)高于单一头颈部CTA[79.69%(51/64)、77.63%(59/76)]、脑CTP[76.56%(49/64)、73.68%(56/76)]检查,差异均有统计学意义(χ^(2)=7.725、9.344,P均<0.05)。联合检查的阴性预测值高于脑CTP检查,差异有统计学意义(P<0.05)。结论 脑CTP联合头颈部CTA具有较高的准确度,能够减少急性缺血性脑卒中漏诊、误诊情况。Objective The diagnostic value of brain CT perfusion(CTP) combined with head and neck CT angiography(CTA) in acute ischemic stroke was analyzed.Methods A total of 76 patients with suspected acute ischemic stroke selected from Caoxian County Hospital from September 2022 to June 2023 were selected as the research objects.All patients underwent brain CTP and head and neck CTA.The results of digital subtraction angiography(DSA) were used as the gold standard to analyze the diagnostic results and diagnostic efficacy of the three methods.Results Among 76 patients with acute ischemic stroke,DSA detected positive in 64 cases,negative in 12 cases;head and neck CTA detected 55 positive cases and 21 negative cases.Brain CTP was positive in 54 cases and negative in 22 cases.Brain CTP combined with head and neck CTA detected 62 positive cases and 14 negative cases.There was no significant difference in the specificity and positive predictive value of single head and neck CTA,brain CTP and combined examination(both P>0.05).The sensitivity and accuracy of combined examination were 93.75%(60/64) and 92.11%(70/76),which were higher than 79.69%(51/64),77.63%(59/76) of single head and neck CTA and 76.56%(49/64),73.68%(56/76) of brain CTP,and the differences were statistically significant(χ~2=7.725,9.344,both P<0.05).The negative predictive value of combined examination was higher than that of brain CTP examination,and the difference was statistically significant(P<0.05).Conclusion Brain CTP combined with head and neck CTA has high accuracy,which can reduce the missed diagnosis and misdiagnosis of acute ischemic stroke.

关 键 词：脑CT灌注成像 头颈部CT血管成像 急性缺血性脑卒中 临床诊断 

分 类 号：R743.3[医药卫生—神经病学与精神病学]