计算机断层扫描灌注图像上行动态强化灶对脑出血进展的预测价值

The Predictive Value of Ascending Dynamic Enhancement on CT Perfusion Images for the Progression of Intracerebral Hemorrhage

目的:评价计算机断层扫描灌注图像上行动态强化灶对脑出血进展的预测价值。方法:选取2017年6月到2018年5月我院神经内科收治的125例发病时间在6h内的脑出血患者,进行CT和CTP检查,根据患者是否出现行动态强化灶分为两组,对行动态强化灶对脑血肿增长预测进行评估分析。结果:检查后发现脑出血增长患者中经复查证实脑出血增长患者为32例(25.6%),出现CTP-SI行动态强化灶为40例(32%);阳性患者中,26例(81.25%)血肿增长,6例(18.75%)无血肿增长;CTP点征预测脑血肿进展灵敏度为83.9%,特异度93.6%,阳性预测值81.3%,阴性预测值94.6%,Kappa=0.767(P<0.001);多因素OR值:16.879(5.749~49.559),P<0.001。结论:CTP-SI中的"动态点征"是具有独立的预测脑内血肿增长的影像征象,可为临床治疗提供更多的指导和依据。

Objective:To evaluate the predictive value of dynamic enhancement lesions upon computed tomography perfusion images in cerebral hemorrhage progression.Methods:125 patients with cerebral hemorrhage within 6 hours who were admitted in our Department of Neurology between June 2017 and May 2018 were divided into 2 groups according to the presence of dynamic enhancement lesions after CT and CTP examination.Dynamic enhancement lesions were used to evaluate the growth prediction of cerebral hematoma.Results:After examination,there were 32 patients(25.6%)with increased cerebral hemorrhage and 40 patients(32%)with dynamic enhancement lesions of CTP-SI.Among the positive patients,there were 26 patients(81.25%)with increased Hematoma,6 patients(18.75%)with no hematoma growth.The predicted cerebral hematoma progression sensitivity of CTP site was 83.9%,93.6%for specificity,81.3%for positive predictive value,94.6%for negative predictive value and Kappa=0.767(P<0.001).multivariate OR values was 16.879(5.749-49.559),P<0.001.Conclusion:The"dynamic site"in CTP-SI is an independent imaging predictor of intracerebral hematoma growth,which can provide more guidance and basis for clinical treatment.