扩散张量成像联合美国国立卫生研究院卒中量表评价老年急性脑梗死患者预后价值

Value of MR diffusion tensor imaging and NIHSS in assessing the outcome of elderly acute ischemic stroke patients

目的分析白质纤维束成像技术及磁共振扩散张量成像在评估急性缺血性脑梗死患者预后中的应用价值。方法选取我院收治的120例单侧急性缺血性脑梗死患者作为研究对象;行磁共振扩散张量成像及白质纤维束成像技术检测,采用平行联合和系列联合进行联合预测分析,若所有指标均为阳性则判定系列联合预测阳性,任一指标为阳性则判定平行联合预测为阳性。结果平行联合预测的敏感性及阴性预测值均显著高于美国国立卫生研究院卒中量表(NIHSS)评分预测、病灶与皮质脊髓束关系预测及系列联合预测(P<0.05)。系列联合预测的特异性及阳性预测值均显著高于NIHSS评分预测、病灶与皮质脊髓束关系预测及平行联合预测(97.50%vs 85.00%、87.50%、78.75%,P=0.001;93.75%vs 73.33%、76.19%、68.52%,P=0.000);平行联合预测及系列联合预测的ROC曲线下面积显著高于NIHSS评分预测、病灶与皮质脊髓束关系预测(P<0.05)。结论依照患者脑梗死病灶与皮质脊髓束关系并联合患者NIHSS评分结果对患者的偏瘫预后进行评估,具有较好的临床应用价值。

Objective To analyze the value of white matter fiber tracer imaging and MR diffusion tensor imaging in assessing the outcome of acute ischemic stroke（AIS）patients.Methods One hundred and twenty unilateral AIS patients were included in this study.Their outcome was detected according to the MR diffusion tensor imaging and white matter fiber beam imaging and analyzed by parallel combination prediction analysis and serial combination prediction analysis.The serial combination prediction analysis was defined positive when its all indexes were positive,the parallel combination prediction analysis was defined positive when its any index was positive.Results The sensitivity and negative value of parallel combination prediction analysis were significantly higher than those of NIHSS score,relationship between lesions and corticospinal tract,and serial combination prediction analysis（P〈0.05）.The specificity and positive value of serial combination prediction analysis were significantly higher than those of NIHSS score,relationship between lesions and corticospinal tract,and parallel combination prediction analysis（97.50% vs85.00%,87.50%,78.75%,P=0.001;93.75% vs 73.33%,76.19%,68.52%,P=0.000）.The area under the ROC curve for parallel combination prediction analysis and serial combination prediction analysis was significantly higher than that for NIHSS score and relationship between lesions and corticospinal tract（P〈0.05）.Conclusion Assessment of the hemiplegia outcome according to the relationship between lesions and corticospinal tract combined with NIHSS score is of a rather high application value in clinical practice.