CTP参数对大脑中动脉狭窄患者预后的预测分析

Predictive Analysis of CTP Parameters on the Prognosis of Patients with Middle Cerebral Artery Stenosis

本文探讨CT灌注扫描(CTP)参数评估大脑中动脉狭窄患者预后、认知功能的应用价值。选取大脑中动脉狭窄患者109例,分析不同预后、认知功能患者脑血容量(CBV)患健比、达峰时间(TTP)患健比、平均通过时间(MTT)患健比和延迟时间(Delay)患健比,分析CBV、TTP、MTT以及Delay患健比预测预后、认知功能障碍的价值。重度狭窄、预后不良大脑中动脉狭窄患者CBV患健比明显低于中度狭窄、预后良好患者(P<0.05),而MTT患健比、Delay患健比明显高于中度狭窄、预后良好患者(P<0.05)。大脑中动脉狭窄伴认知功能障碍患者CBV患健比明显低于不伴认知功能障碍患者(P<0.05)。CBV患健比、MTT患健比、Delay患健比预测大脑中动脉狭窄预后不良的ROC曲线下面积分别为0.852、0.677和0.895(P<0.05)。CBV患健比预测大脑中动脉狭窄伴认知功能障碍的ROC曲线下面积为0.700(P<0.05)。CBV、MTT及Delay患健比在预测大脑中动脉狭窄患者预后、认知功能方面有一定应用价值。

This study explored the application value of CT perfusion(CTP)parameters in evaluating the prognosis and cognitive function of patients with middle cerebral artery stenosis.Selected 109 patients with middle cerebral artery stenosis and analyzed the ratio of affected side to healthy side of cerebral blood volume(CBV),time to peak(TTP),mean transit time(MTT)and delay time(Delay)in patients with different prognosis and cognitive function,as well as the value of CBV,TTP,MTT and Delay patient health ratio in predicting prognosis and cognitive impairment.The ratio of affected side to healthy side of CBV in patients with middle cerebral artery severe stenosis and poor prognosis was significantly lower than that in patients with moderate stenosis and good prognosis(P<0.05).The ratio of affected side to healthy side of MTT and Delay were significantly higher than those with moderate stenosis and good prognosis(P<0.05).The ratio of affected side to healthy side of CBV in patients with middle cerebral artery stenosis and cognitive impairment was significantly lower than that in patients without cognitive impairment(P<0.05).The areas under the ROC curve of ratio of affected side to healthy side of CBV,MTT and Delay in predicting middle cerebral artery stenosis poor prognosis were 0.852,0.677 and 0.895,respectively(P<0.05).The area under the ROC curve of ratio of affected side to healthy side of CBV in predicting middle cerebral artery stenosis with cognitive impairment was 0.700(P<0.05).The ratio of affected side to healthy side of CBV,MTT and Delay patient health ratio have certain application value in predicting the prognosis and cognitive function of patients with middle cerebral artery stenosis.