颅脑CT+CTA及颅脑MRI平扫在脑缺血性疾病中的应用价值

The application value of CT+CTA and MRI in cerebral ischemic disease

目的:探讨颅脑CT+CT血管成像(CTA)及颅脑磁共振(MRI)平扫在脑缺血性疾病中的应用价值。方法:选取2020年1月—2022年10月在廊坊市人民医院就诊的脑缺血性疾病患者100例,给予颅脑CT+CTA及颅脑MRI平扫检查。结果:CT+CTA与MRI脑缺血性疾病检出率分别为92.00%和96.00%,差异无统计学意义(P>0.05)。发病至入院检查<6 h、6~24 h、>24 h患者的CT+CTA检出率、MRI检出率比较差异无统计学意义(P>0.05)。预后不良患者年龄为(70.04±10.02)岁,高于预后良好患者,差异有统计学意义(P<0.05);预后不良患者CTA侧支循环评分低于预后良好患者,差异有统计学意义(P<0.05),其CTA侧支循环评分≤2分比例达到83.72%。CTA侧支循环评分预测预后不良的受试者工作特征(ROC)曲线下面积为0.771(95%CI:0.680~0.862),截断值为≤2分,预测预后不良的灵敏度和特异度分别为63.40%和82.60%。结论:颅脑CT+CTA及颅脑MRI平扫在脑缺血性疾病诊断中均有较好的应用价值,其中CTA在预测患者预后方面有一定作用。

Objective To explore the application value of CT+CT angiography(CTA)and brain magnetic resonance imaging(MRI)plain scan in cerebral ischemic disease.Methods 100 patients with cerebral ischemic disease in Langfang People's Hospital from January 2020 to October 2022 were selected,CT+CTA and MRI were performed.Results The detection rates of cerebral ischemic disease in CT+CTA and MRI were 92.00%and 96.00%,respectively,the difference was not statistically significant(P>0.05).There was no statistically significant difference in CT+CTA detection rate and MRI detection rate between patients with<6 h,6-24 h and>24 h from onset to admission(P>0.05).The age of patients with poor prognosis was(70.04±10.02)years old,which was significantly higher than that of patients with good prognosis(P<0.05).CTA collateral circulation score in patients with poor prognosis was significantly lower than that in patients with good prognosis(P<0.05),and the proportion of CTA collateral circulation score≤2 reached 83.72%.The area under the ROC curve of CTA collateral circulation score predicting poor prognosis was 0.771(95%CI:0.680-0.862),and the cut-off value was≤2 points,the sensitivity and specificity of CTA collateral circulation score predicting poor prognosis were 63.40%and 82.60%,respectively.Conclusion Brain CT+CTA and MRI plain scan have good application value in the diagnosis of cerebral ischemic diseases,among which CTA plays a certain role in predicting the prognosis of patients.