CTP联合头颈部CTA在缺血性脑卒中临床诊断中的应用价值探讨

The clinical value of CTP combined with CTA in the diagnosis of ischemic stroke

目的探讨CTP联合头颈部CTA在缺血性脑卒中临床诊断中的应用价值。方法此研究选取2018年7月-2023年7月北京市平谷区中医医院收治的98例疑似缺血性脑卒中患者作为研究对象,所有患者入院后均进行CTP、CTA及DSA检查,对其临床资料进行回顾性分析。结果98例疑似缺血性脑卒中患者中有68例患者确诊为缺血性脑卒中。CTP+CTA联合检查对缺血性脑卒中的检出率、准确性、敏感性、特异性、漏诊率、误诊率分别为73.47%、95.92%、100.00%、86.67%、0.00%、13.33%。CTA对血管狭窄或闭塞的检测与DSA结果的符合率为86.76%。缺血核心区CBF、CBV显著低于缺血半暗带区和镜像对照区(P<0.05),缺血核心区MTT、TTP显著长于缺血半暗带区和镜像对照区(P<0.05);缺血半暗带区CBF、CBV显著低于镜像对照区(P<0.05),MTT、TTP显著长于镜像对照区(P<0.05)。结论CTP、CTA联合检查用于缺血性脑卒中的诊断具有较高的准确性、特异性和敏感性,同时误诊率和漏诊率较低,可用于缺血性脑卒中的临床诊断。

Objective To explore the clinical value of CTP combined with CTA in the diagnosis of ischemic stroke(IS).Methods 98 patients with suspected IS admitted to our hospital from July 2018 to July 2023 were selected,all patients underwent CTP,CTA and DSA,the clinical data were analyzed retrospectively.Results In 98 patients with suspected IS,68 patients were finally diagnosed as IS.The detection rate,accuracy,sensitivity,specificity,missed diagnosis rate and misdiagnosis rate of CTP+CTA were 73.47%,95.92%,100.00%,86.67%,0.00% and 13.33%.The coincidence rate of detection of vascular stenosis or occlusion between CTA and DSA was 86.76%.CBF and CBV in the ischemic core were significantly lower than those in the ischemic penumbra and mirror control(P<0.05),while MTT and TTP were significantly longer than those in the ischemic penumbra and Mirror Control(P<0.05).CBF and CBV in ischemic penumbra were significantly lower than those in mirror control(P<0.05),while MTT and TTP were significantly longer than those in mirror control(P<0.05).Conclusion The combined examination of CTP and CTA has high accuracy,specificity and sensitivity in the diagnosis of IS,and the rate of misdiagnosis and missed diagnosis is low.It can be used for clinical diagnosis of IS.