CT灌注成像对超急性脑梗死半暗带两种判定方法的一致性研究

Consistency between two methods for penumbra assessment by CT perfusion in hyperacute cerebral ischemia

目的探讨CT灌注成像缺血半暗带两种判定方法的一致性.方法采用GELightSpeed 16 MSCT对10例超急性脑缺血患者进行CT灌注成像和复查CT.采用两种方法判定半暗带,一种是计算半暗带阈值以判定半暗带(对比法),另一种是将CBV与CBF图上变化不一致的区域判断为半暗带(不匹配法).结果半暗带阈值(CBF%)为0.20～0.66,两种方法间一致性系数Kappa(K)为0.7877.ROC曲线显示对比法的诊断效能高于不匹配法.结论 CT灌注成像判定半暗带的两种方法具有较好的一致性.

Objective To evaluate the consistency between two reported methods for assessing the penumbra in hyperacute cerebral ischemia by CT perfusion. Methods Ten hyperacute cerebral ischemic patients were performed CT perfusion and follow up scans after a week with a GE Lightspeed 16 MSCT. The penumbra was determined by two methods. The penumbra was determined by threshold value which were calculated by comparison the follow up scan with CTP results in the contrast method. Another was the mismatch of the CBV and CBF (the mismatch method). Results The threshold value of the penumbra (CBF%) was 0.20-0.66. The consistency coefficient Kappa (K) of the two methods was 0.7877. ROC curve showed that the contrast method had higher diagnostic efficacy than the mismatch method. Conclusion A high consistency was found between the two methods for identifying the penumbra.