CT血管成像技术与灌注成像技术对急性缺血性脑卒中侧支循环诊断敏感度与准确率的影响

Effect of CT Angiography and Perfusion Imaging on the Sensitivity and Accuracy of Diagnosis of Collateral Circulation in Acute Ischemic Stroke

目的探讨CT血管成像技术(computed tomography angiography,CTA)与灌注成像技术(computed tomography perfusion imag⁃ing,CTP)扫描急性缺血性脑卒中(acute ischemic stroke,AIS)侧支循环对其诊断准确率与敏感性的临床影响。方法选取靖江市人民医院2018年6月—2021年10月收治的AIS患者70例,分别开展CTA与CTP扫描,比较两种方法诊断侧支循环的准确性与敏感度。结果以DSA检查结果为金标准,CTA诊断准确率为90.00%,敏感度为90.48%,特异度为89.29%;CTP诊断准确率为87.14%,敏感度为88.10%,特异度为85.71%;CTP检查ROI灌注区域参数显示有侧支循环组患侧CBF、CBV依次为(57.89±4.28)mL/(100 g·min)、(2.58±0.30)mL/100 g低于同组健侧(61.41±3.86)mL/(100 g·min)、(2.60±0.36)mL/100 g,差异有统计学意义(t=3.232、2.088,P<0.05),且高于无侧支循环组患侧,差异有统计学意义(t=3.851、2.244,P<0.05);患侧MTT与TTP高于同组健侧且低于无侧支循环组患侧,差异有统计学意义(t=5.625、6.736、3.398、5.766,P<0.05);无侧支循环组患侧CBF低于同组健侧,MTT与TTP高于同组健侧,差异有统计学意义(P<0.05)。结论CTA与CTP扫描AIS侧支循环的准确率与敏感度相近,临床可结合实际合理选择或采取二者联合的方式以提高诊断准确性。

Objective To investigate the clinical impact of CT angiography(CTA)and perfusion imaging(CTP)on the diagnostic accuracy and sensitivity of scanning the collateral circulation in acute ischemic stroke(AIS).Methods 70 AIS patients admitted to Jingjiang People's Hospital from June 2018 to October 2021 were selected for CTA and CTP scanning to compare the accuracy and sensitivity of the two methods in diagnosing collateral circulation.Results With DSA as the gold standard,the diagnostic accuracy of CTA was 90.00%,the sensitivity was 90.48%,and the specificity was 89.29%.The diagnostic accuracy,sensitivity and specificity of CTP were 87.14%,88.10%and 85.71%respectively.The parameters of ROI perfusion area measured by CTP showed that CBF and CBV in the affected side of the group with collateral circulation were(57.89±4.28)mL/(100 g·min),(2.58±0.30)mL/100 g lower than those in the healthy side of the same group(61.41±3.86)mL/(100 g·min),(2.60±0.36)mL/100 g,the difference was statistically significant(t=3.232,2.088,P<0.05),and higher than those in the group without collateral circulation,the difference was statistically significant(t=3.851,2.244,P<0.05).MTT and TTP in the affected side were higher than those in the healthy side of the same group and lower than those in the non collateral circulation group,the difference was statistically significant(t=5.625,6.736,3.398,5.766,P<0.05).The CBF of the affected side in the non collateral circulation group was lower than that of the healthy side in the same group,and the MTT and TTP were higher than that of the healthy side in the same group,the difference was statistically significant(P<0.05).Conclusion The accuracy and sensitivity of CTA and CTP scans of AIS collateral circulation are similar,and the clinical practice can reasonably choose or adopt the combination of both to improve the diagnostic accuracy.