彩色多期CT血管成像对脑大、中动脉闭塞性脑梗死的诊断价值

The value of color multi-phase CT angiography(ColorViz mCTA)in the diagnosis of large and medium cerebral infarcts caused by cerebral artery occlusion

目的探讨彩色多期CT血管成像(ColorViz mCTA)对大、中动脉闭塞性脑梗死的诊断价值。方法选取本院急性缺血性脑卒中患者306例,均完成多期CTA及MRI-DWI检查。多期CTA血管信息由FastStroke软件汇总。对比ColorViz mCTA对于大、小梗死灶的检出差异性,分析ColorViz mCTA与区别大、小病灶之间的相关性,利用ROC曲线评价ColorViz mCTA对区分大、小急性脑梗塞灶的诊断价值。结果共检出323个病灶,其中大、中动脉闭塞性梗死灶共190个,小动脉闭塞性脑梗死灶133个。病灶越大,ColorViz mCTA检出率越高(P<0.001),并且ColorViz mCTA与病灶大小有显著相关性(r=0.749,P<0.001);ColorViz mCTA区分大、小病灶曲线下面积(AUC)为0.933(P<0.001),当病灶面积等于2.53 cm2时,ColorViz mCTA具有最大诊断效能,敏感度为91.1%,特异度为86.1%。结论利用ColorViz mCTA可对脑大、中动脉闭塞性脑梗死针对性诊断。

Objective To explore the diagnostic value of ColorViz multi phase CT angiography(ColorViz mCTA)in large and middle artery occlusion cerebral infarction.Methods A total of 306 patients with acute ischemic stroke in our hospital were selected.All patients were completed multi-phase CTA and MRI-DWI examination.Multi stage CTA vascular information was summarized by FastStroke software.Then,we compared the differential detection of ColorViz mCTA for large and small infarcts,analyzed the correlation between ColorViz mCTA and distinguishing large and small infarcts,and evaluated the diagnostic value of ColorViz mCTA for distinguishing the large and small acute cerebral infarction using receiver operating characteristic curve(ROC).Results A total of 323 lesions were detected,there were 190 cases of large and middle artery occlusive infarction and 133 cases of small artery occlusive cerebral infarction.The larger the lesion,the higher the detection rate of ColorViz mCTA(P<0.001),and there was a significant correlation between ColorViz mCTA and lesion size(r=0.749,P<0.001);ColorViz mCTA could distinguish the large and small lesions with an area under the curve(AUC)of 0.933(P<0.001).When the lesion area was equal to 2.53 cm2,ColorViz mCTA had the maximum diagnostic efficacy,with a sensitivity of 91.1%and a specificity of 86.1%.Conclusion ColorViz mCTA can be used for the targeted diagnosis of large and medium cerebral infarcts caused by cerebral artery occlusion.