CT全脑灌注联合头颈部CT血管造影诊断缺血性脑卒中的临床价值

The clinical value of CT whole brain perfusion combined with head and neck CT angiography in the diagnosis of ischemic stroke

目的探究CT全脑灌注联合头颈部CT血管造影诊断缺血性脑卒中的临床价值。方法选取2019年5月至2020年12于本院接受检查的85例疑似缺血性脑卒中患者作为研究对象。患者均接受头颈部CT血管造影、CT全脑灌注诊断,以病理检查为金标准,比较CT全脑灌注、头颈部CT血管造影、CT全脑灌注联合头颈部CT血管造影的诊断符合率、灵敏度、特异度、阳性预测值、阴性预测值、漏诊率和误诊率。结果病理检查结果显示,85例患者中阳性62例,阴性23例。联合诊断符合率、灵敏度、特异度、阳性预测值、阴性预测值均高于CT全脑灌注、头颈部CT血管造影,漏诊率、误诊率均低于CT全脑灌注、头颈部CT血管造影,差异有统计学意义(P<0.05);CT全脑灌注与头颈部CT血管造影符合率、灵敏度、特异度、阳性预测值、阴性预测值、漏诊率、误诊率比较差异无统计学意义。结论在缺血性脑卒中诊断中采用CT全脑灌注联合头颈部CT血管造影,能有效提高诊断符合率、灵敏度和特异度,应用价值显著。

Objective To explore the clinical value of CT whole brain perfusion combined with head and neck CT angiography in the diagnosis of ischemic stroke.Methods 85 suspected ischemic stroke patients who underwent examination in our hospital from May 2019 to December 2020 were selected as the study subjects.All patients underwent head and neck CT angiography and CT whole brain perfusion,pathological examination was used as the gold standard to compare the diagnostic accuracy,sensitivity,specificity,positive predictive value,negative predictive value,missed diagnosis rate and misdiagnosis rate of CT whole brain perfusion,head and neck CT angiography,CT whole brain perfusion combined with head and neck CT angiography.Resluts The results of pathological examination showed that 62 cases were positive and 23 cases were negative in 85 patients.The accuracy,sensitivity,specificity,positive predictive value and negative predictive value in the combined diagnosis were higher than those in the CT whole brain perfusion and head and neck CT angiography,and the missed diagnosis rate and misdiagnosis rate were lower than those in the CT whole brain perfusion and head and neck CT angiography,the differences were statistically significant(P<0.05);there were no significant differences in the accuracy,sensitivity,specificity,positive predictive value,negative predictive value,missed diagnosis rate and misdiagnosis rate between CT whole brain perfusion and head and neck CT angiography.Conclusion The use of CT whole brain perfusion combined with head and neck CT angiography in the diagnosis of ischemic stroke can effectively improve the diagnostic accuracy,sensitivity,and specificity,and has significant application value.