CTA、CTP对急性缺血性卒中患者梗死体积的评估价值

Evaluation value of CTA and CTP on infarct volume in patients with acute ischemic stroke

目的:研究CT血管造影(CTA)、CT灌注(CTP)对急性缺血性卒中(AIS)患者梗死体积的评估价值。方法:回顾性分析本院100例AIS患者临床资料,所有患者均接受CTA与CTP检查,记录患者梗死体积。分析CTA与CTP对判断梗死体积的临床价值。结果:100例患者中大体积梗死者36例,为观察组,余64例为对照组。两组患者血管狭窄程度差异显著(P<0.05)。两组患者脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)及达峰时间(TTP)水平差异有统计学意义(P<0.05)。CTA血管狭窄程度判断梗死体积的曲线下面积(AUC)为0.743(S.E.=0.109,P=0.048,95%CI=0.528-0.958),敏感度为0.778,特异度为0.572。CTP血流参数联合检测对判断梗死体积具有较高价值(AUC=0.826,P=0.008,95%CI=0.619-1.000),敏感度为0.875,特异度为0.778。结论:CTA与CTP用于AIS患者有助于判断脑梗死体积,为预测脑血管事件提供依据。

Objective To investigate the evaluation value of CT angiography(CTA)and CT perfusion(CTP)on infarct volume in patients with acute ischemic stroke(AIS).Methods The clinical data of 100 AIS patients in our hospital were retrospectively analyzed,all patients underwent CTA and CTP examinations,and the infarct volume was recorded.The clinical value of CTA and CTP in judging the infarct volume were analyzed.Results Of the 100 patients,36 cases had large infarcts,which were the observation group,and the remaining 64 cases were the control group.The degree of vascular stenosis between the two groups was significantly different(P<0.05).There were statistically significant differences in the levels of cerebral blood volume(CBV),cerebral blood flow(CBF),mean transit time(MTT)and time to peak(TTP)between the two groups(P<0.05).The area under curve(AUC)for judging the infarct volume by CTA stenosis was 0.743(S.E.=0.109,P=0.048,95%CI=0.528-0.958),the sensitivity and the specificity were 0.778 and 0.572,respectively.The combined detection of CTP blood flow parameters is of high value in judging the infarct volume(AUC=0.826,P=0.008,95%CI=0.619-1.000),with a sensitivity of 0.875 and a specificity of 0.778.Conclusion CTA and CTP used in AIS patients are helpful to judge the volume of cerebral infarction and provide a basis for predicting cerebrovascular events.