多模式CT在急性前循环脑卒中患者侧支循环评估及预后的应用

Application of Multimodal CT in Assessment and Prognosis of Collateral Circulation in Patients with Acute Anterior Circulation Stroke

目的:探讨多模式CT对急性前循环缺血性脑卒中患者侧支循环及临床预后的评估价值。方法:纳入50例临床确诊的急性前循环脑卒中患者,均于治疗前行多时相CT血管成像(mCTA)和CT灌注成像(CTP)检查。收集患者核心梗死区、缺血半暗带及健侧对照区CTP检查参数,依改良Rankin评分(mRS评分)分为预后良好和预后不良组,比较两组CTP灌注参数的差异;用Monen评分法对mCTA进行侧支评估,比较良好侧支组与不良侧支组90d美国国立卫生研究院卒中量表(NHISS)评分、mRS评分的差异。结果:与不良预后组对比,良好预后组可观察到较高的rCBV;mCTA侧支评估良好组与不良组对比,90d时NHISS、mRS评分较低,神经功能缺损较轻,预后较好。结论:多模式CT可较好评估脑卒中患者侧支循环情况,对神经功能缺损及临床预后有一定的指示作用。

Objective:To evaluate the value of multi-mode CT in evaluating collateral circulation and clinical prognosis in patients with acute anterior circulation ischemic stroke.Methods:A total of 50 clinically diagnosed patients with acute procirculatory stroke were enrolled.They were examined by multi-temporal CT angiography(mCTA)and CT perfusion imaging(CTP)before treatment.The CTP parameters of the core infarction area,ischemic penumbral zone and healthy control area were collected,patients were divided into good prognosis group and poor prognosis group according to the modified Rankin score(mRS score).The differences of CTP perfusion parameters between the two groups were compared.The Monen score was used to evaluate the mCTA lateral branches,and the differences of 90-day NHISS score and mRS Score between the good and bad lateral branches were compared.Results:Compared with the poor prognosis group,rCBV was higher in the good prognosis group.At 90 days,we found the good mCTA collateral assessment group had lower NHISS and mRS scores,less neurological impairment,and a better prognosis.Conclusion:Multi-modal CT can better evaluate the collateral circulation of stroke patients,has a certain indication of neurological function deficit and clinical prognosis.