大面积脑梗死的多层螺旋CT诊断价值及检出率分析

Diagnostic Value and Detection Rate of Multi-slice Spiral CT in Large Area Cerebral Infarction

目的:探讨多层螺旋CT(MSCT)诊断大面积脑梗死的价值。方法:以230例疑似大面积脑梗死患者为对象,在0-6h、12-24h、24-72h均接受MSCT扫描,分析MSCT的诊断价值。结果:230例疑似大面积脑梗死患者中196例(85.22%)确诊。MSCT诊断大面积脑梗死的灵敏度为58.16%(114/196)、特异度为100.00%(34/34),阳性预测值为100.00%、阴性预测值为29.31%、准确率为64.34%、Kapp值为0.82。大面积脑梗死患者梗死侧局部脑血流量(rBGF)、局部脑血管容积(rCBV)、平均通过时间(MTT)水平均低于对照组(P<0.05)。MSCT诊断0-6h、12-24h、24-72h大面积脑梗死的准确率分别为58.16%(114/230)、94.39%(185/196)、100.00%(196/196)。结论:MSCT检查诊断超急性大面积脑梗死具有一定的价值,结合患者症状、体征可提高诊断的准确性。

Objective:To explore the value of multi-slice spiral CT(MSCT)in the diagnosis of large-area cerebral infarction.Methods:A total of 230 patients with suspected massive cerebral infarction were enrolled and received MSCT scans at 0-6h,12-24h,and 24-72h to analyze the diagnostic value of MSCT.Results:Among 230 patients with suspected massive cerebral infarction,196(85.22%)were diagnosed.The sensitivity of MSCT in the diagnosis of large-area cerebral infarction was 58.16%(114/196),the specificity was 100.00%(34/34),the positive predictive value was 100.00%,the negative predictive value was 29.31%,the accuracy was 64.34%,and the Kapp value is 0.82.The levels of regional cerebral blood flow(rCBF),regional cerebral vascular volume(rCBV)and mean transit time(MTT)in patients with massive cerebral infarction were lower than those in the control group(P<0.05).The accuracy rates of MSCT in diagnosing large-area cerebral infarction at 0-6h,12-24h,and 24-72h were 58.16%(114/230),94.39%(185/196),and 100.00%(196/196),respectively.Conclusion:MSCT examination has a certain value in the diagnosis of hyperacute largearea cerebral infarction,and the combination of symptoms and signs of patients can improve the accuracy of diagnosis.