CT灌注成像用于急性脑梗死患者的预后评估

Application of Perfusion CT in Predicting Clinical Outcome of Patients with Acute Cerebral Infarction

目的:探讨CT灌注成像(PCT)得到的梗死核心、缺血半暗带与急性脑梗死患者临床预后的相关性。方法:回顾性分析78例急性前循环脑梗死患者。利用PCT评估梗死核心体积、缺血半暗带体积。随访90 d的mRS评分,利用多因素线性回归分析判定PCT与临床预后的相关性。结果:年龄是预后最重要的预测因素(P<0.01)。基线NIHSS评分(P=0.021)和HMCAS(P=0.038)与预后呈负相关。与ICA(和M1)闭塞相比,M1闭塞相对预后较好(P=0.012)。血管再通与否也是预后的显著影响因素(P=0.010)。PCT得出的梗死核心体积并不能准确预测预后(P=0.145),PCT测出的半暗带体积与预后呈正相关(P=0.044)。结论:PCT有利于急性脑梗死超早期的治疗决策及早期预后的评估。

ObjectiveTo investigate the correlation between the variables conducted by Perfusion CT （PCT） and clinical outcome of acute cerebral infarction. Methods：In all, 78 patients with anterior circulation acute cerebral infarction were enrolled in this observation. Their infarct core and penumbra were accessed by PCT. Modified Rankin scale （mRS） was used to followe up the participants 90 days after onset. The correlation between Perfusion CT and clinical outcome was analyzed by multi-variables linear regression analysis. Results：Age was the most important factor to predict the clinical outcome （ P〈0.01）. Both NIHSS and HMCAS were negatively correlated with 90-days mRS （P =0.021 and 0.038）. When compared with the ICA occlusion, patients with M1 oc-clusion had relatively better prognosis （P =0.012）. Recanalization of vessels was a significant factor affecting the prognosis （P =0.010）. The infarct volume in PCT could not accurately predict the prognosis （P =0.145）, and the penumbra volume in PCT was positively correlated with prognosis （P =0.044）. Conclusion：PCT is useful in de-ciding the therapeutic strategy and predicting the outcome in early stage of acute cerebral infarction patients.