CTP评价脑血流动力学参数对脑梗死的诊断

Evaluation of Cerebral Hemodynamic Parameters by CTP in the Diagnosis of Cerebral Infarction

目的:探讨CT灌注成像(CT perfusion imaging,CTP)测定脑血流动力学参数对急性脑梗死患者的诊断价值。方法:选取2020年6月至2021年12月医院收治的40例疑似急性脑梗死患者进行研究,均进行CTP检查,诊断金标准为临床确诊结果,分析CTP检查的诊断准确性。另外选择同期30例健康志愿者为对照组,行CTP检查,比较脑梗死区和正常脑区的脑血流量(cerebral blood flow,CBF)、脑血容量(cerebral blood volume,CBV)、平均通过时间(mean transmit time,MTT)、达峰时间(time to peak,TTP)等脑血流动力学参数。结果:经临床确诊的37例急性脑梗死患者中,CTP检查确诊35例(94.59%)。CTP的诊断敏感性、特异性、准确度分别为91.89%、66.67%、90.00%。CTP诊断结果与临床确诊结果比较差异无统计学意义(P>0.05)。梗死脑区的CBV、CBF均低于正常脑区,TTP、MTT均长于正常脑区(t=7.762,P=0.000;t=17.243,P=0.000;t=6.313,P=0.000;t=10.763,P=0.000)。结论:CTP诊断急性脑梗死患者的准确率高,可准确评估脑患者的血流动力学,可以清楚获得脑梗死区的病灶分布及脑区血流等,对临床治疗提供指导依据。

Objective:To explore the diagnostic value of CT perfusion imaging(CTP)for the determination of cerebral hemodynamic parameters in patients with acute cerebral infarction.Methods:Forty patients with suspected acute cerebral infarction admited to the hospital from June 2020 to December 2021 were selected for the study.All patients underwent CTP examination.The gold standard for diagnosis was the clinical diagnosis result.In addition,30 healthy volunteers during the same period were selected as the control group,and underwent CTP examination to compare the cerebral blood flow(CBF),cerebral blood volume(CBV),and average transit time between the cerebral infarction area and the normal brain area.Cerebral hemodynamic parameters such as mean transmit time(MTT)and time to peak(TTP).Results:Among the 37 clinically diagnosed patients with acute cerebral infarction,35(94.59%)were confirmed by CTP examination.The diagnostic sensitivity,specificity and accuracy of CTP were 91.89%,66.67%and 90.00%,respectively.There was no signifcant difference between the results of CTP diagnosis and clinical diagnosis(P>0.05).The CBV and CBF in the infarcted brain region were lower than those in the normal brain region,and the TTP and MTT were longer than those in the normal brain region(t=7.762,P=0.000;t=17.243,P=0.000;t=6.313,P=0.000;t=10.763,P=0.000).Conclusion:CTP has a high accuracy rate in diagnosing patients with acute cerebral infarction,can accurately assess the hemodynamics of cerebral patients,and can clearly obtain the distribution of lesions in the cerebral infarction area and the blood flow in the cerebral area,which can provide guidance for clinical treatment.