双源CT灌注成像参数预测缺血性脑卒中患者预后研究  

Prediction of Prognosis in Ischemic Stroke Patients Using Dual-Source CT Perfusion Imaging Parameters

作　　者：杨延梦 王光明 程昱昊 张俊涛 胡祖航 唐艳隆 Yang Yanmeng;Wang Guangming;Cheng Yuhao;Zhang Juntao;Hu Zuhang;Tang Yanlong(Department of Radiology,The First Affiliated Hospital of Dali University,Dali,Yunnan 671000,China;Gene Testing Center,The First Affiliated Hospital of Dali University,Dali,Yunnan 671000,China)

机构地区：[1]大理大学第一附属医院放射科,云南大理671000 [2]大理大学第一附属医院基因检测中心,云南大理671000

出　　处：《大理大学学报》2025年第4期65-69,共5页Journal of Dali University

基　　金：云南省地方本科高校基础研究联合专项资金项目(202001BA070001-149);云南省卫生健康委员会医学后备人才培养计划(H-2018010)。

摘　　要：目的:探讨双源CT灌注成像(CTPI)参数对缺血性脑卒中患者预后的评估价值。方法:将2022年3月至2024年2月大理大学第一附属医院收治的90例缺血性脑卒中患者纳入研究。患者均行CTPI检查,获取脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)、排泄时间(TTD)、剩余脑血流量达峰时间(TMAX)等成像参数。根据出院时改良Rankin量表(mRS)评分将患者分为预后良好组和预后不良组。对比2组患者CTPI成像参数,并分析患侧与健侧CTPI参数差异。采用Spearman相关分析探讨CTPI参数与预后的关系,同时评估梗死体积、半影体积及峰值再循环率对预后的影响,通过受试者操作特征曲线(ROC曲线)分析CTPI参数对预后的预测价值。结果:预后不良组CBF、CBV显著低于预后良好组,MTT、TTD、TMAX显著延长;患侧区CBF、CBV显著低于健侧区,MTT、TTD、TMAX显著延长,差异均有统计学意义(P<0.05)。Spearman分析显示,CBF、CBV与预后呈负相关,MTT、TTD、TMAX以及半影体积与预后呈正相关。ROC曲线分析显示,CBF、MTT和TTD对预后具有较高预测价值。结论:双源CTPI成像参数可有效评估缺血性脑卒中患者的预后,CBF、CBV降低及MTT、TTD、TMAX延长提示预后不良。CTPI成像在缺血性脑卒中早期诊疗和预后评估中具有重要临床意义。Objective:To explore the prognostic value of dual-source CT perfusion imaging(CTPI)parameters in ischemic stroke patients.Methods:Ninety ischemic stroke patients admitted to the First Affiliated Hospital of Dali University from March 2022 to February 2024 were included.CTPI was performed to obtain cerebral blood flow(CBF),cerebral blood volume(CBV),mean transit time(MTT),time to drain(TTD),and time to maximum(TMAX).Patients were categorized into favorable and unfavorable prognosis groups based on the modified Rankin Scale(mRS)scores at discharge.CTPI parameters were compared between the two groups,and differences between the affected and unaffected hemispheres were analyzed.Spearman correlation was used to examine relationships between CTPI parameters and prognosis,and the impact of infarct volume,penumbra volume,and peak reciculation rate on prognosis was evaluated.Receiver operator characteristic(ROC)curves were generated to assess the predictive value of CTPI parameters.Results:The unfavorable prognosis group had significantly lower CBF and CBV,and prolonged MTT,TTD,and TMAX compared with the favorable prognosis group.In the affected hemisphere,CBF and CBV were significantly reduced,while MTT,TTD,and TMAX were notably prolonged compared with the unaffected hemisphere(P<0.05).Spearman analysis revealed negative correlations between CBF,CBV and prognosis,while MTT,TTD,TMAX,and penumbra volume were positively correlated with poor prognosis.ROC curve analysis showed that CBF,MTT,and TTD had high predictive value for prognosis.Conclusion:Dual-source CTPI parameters effectively evaluate the prognosis of ischemic stroke patients.Reduced CBF or CBV and prolonged MTT,TTD,and TMAX indicate poor prognosis.CTPI is of great clinical significance for early diagnosis and prognosis assessment in ischemic stroke.

关 键 词：双源CT灌注成像 缺血性脑卒中 改良Rankin量表 预后 

分 类 号：R445[医药卫生—影像医学与核医学]