全脑CT灌注成像扫描参数对缺血性脑卒中侧支循环的评估价值  

The evaluation value of whole brain CT perfusion imaging scanning parameters on collateral circulation in ischemic stroke

作　　者：金璐 郭小玲 王涛[3] 董天 王长远 盛军 JIN Lu;GUO Xiaoling;WANG Tao;DONG Tian;WANG Changyuan;SHENG Jun(CT Room,the First Affiliated Hospital of Anhui University of Science and Technology,Huainan,Anhui Province 232001,China;Stroke Center,the First Affiliated Hospital of Anhui University of Science and Technology,Huainan,Anhui Province 232001,China;Department of Neurology,the First Affiliated Hospital of Anhui University of Science and Technology,Huainan,Anhui Province 232001,China)

机构地区：[1]安徽理工大学第一附属医院CT室,安徽淮南232001 [2]安徽理工大学第一附属医院卒中中心,安徽淮南232001 [3]安徽理工大学第一附属医院神经内科,安徽淮南232001

出　　处：《实用放射学杂志》2025年第3期368-371,共4页Journal of Practical Radiology

基　　金：安徽高校自然科学研究重点项目计划(KJ2020A0337)。

摘　　要：目的 分析全脑CT灌注成像(CTPI)扫描参数对缺血性脑卒中侧支循环的评估价值.方法 选取102例缺血性脑卒中患者,根据病情分为轻度组(n=26)、中度组(n=56)和重度组(n=20).基于动态CT血管成像改良美国介入和治疗神经放射学协会(ASITN)/介入放射学协会(SIR)评分评估侧支循环状态,分为良好组(n=61)和不良组(n=41).比较不同组间患者CTPI参数[脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)、达峰时间(TTP)].结果 重度组CBF、CBV小于轻、中度组,MTT、TTP大于轻、中度组(P<0.05);中度组CBF、CBV小于轻度组,MTT、TTP大于轻度组(P<0.05).良好组CBF、CBV大于不良组,MTT、TTP小于不良组(P<0.05).受试者工作特征(ROC)曲线分析显示,CBF、CBV、MTT、TTP预测侧支循环不良的敏感度分别为0.820、0.672、0.803和0.820;特异度分别为0.854、0.756、0.732和0.780.结论 CTPI扫描参数用于评估缺血性脑卒中患者颅内侧支循环状态具有一定价值.Objective To analyze the evaluation value of whole brain computed tomography perfusion imaging(CTPI)scanning parameters on collateral circulation in ischemic stroke.Methods One hundred and two patients with ischemic stroke were selected,according to the condition they were divided into mild group(n=26),moderate group(n=56),and severe group(n=20).The collateral circulation status was evaluated based on the modified American Society of Interventional and Therapeutic Neuroradiology(ASITN)/Society of Interventional Radiology(SIR)score of dynamic CT angiography,and was divided into good group(n=61)and poor group(n=41).CTPI parameters were compared between different groups of patients with cerebral blood flow(CBF),cerebral blood volume(CBV),mean transit time(MTT),and time to peak(TTP).Results The CBF and CBV in the severe group were lower than those in the mild and moderate groups,while the MTT and TTP were higher than those in the mild and moderate groups(P<0.05);The CBF and CBV in the moderate group were lower than those in the mild group,while the MTT and TTP were higher than those in the mild group(P<0.05).The CBF and CBV in the good group were higher than those in the poor group,while the MTT and TTP were lower than those in the poor group(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the sensitivity of CBF,CBV,MTT,and TTP in predicting poor collateral circulation was 0.820,0.672,0.803,and 0.820,respectively;The specificity was 0.854,0.756,0.732,and 0.780,respectively.Conclusion CTPI scanning parameters have certain values to assess the intracranial collateral circulation status in patients with ischemic stroke.

关 键 词：CT灌注成像 缺血性脑卒中 侧支循环 脑血流量 脑血容量 平均通过时间 达峰时间 

分 类 号：R814.42[医药卫生—影像医学与核医学] R743[医药卫生—放射医学]