CTP联合3D-ASL在缺血性脑卒中诊断与预后评估中的作用

Effect of CT perfusion imaging combined with three-dimensional arterial spin labeling in the diagnosis and prognosis evaluation of ischemic stroke

目的分析CT灌注成像(CTP)联合三维动脉自旋标记(3D-ASL)在缺血性脑卒中诊断与预后评估中的临床应用价值。方法以2022-12—2023-12在三亚市人民医院就诊的缺血性脑卒中疑似患者120例为对象,所有患者均接受CTP、3D-ASL、DSA检查,以DSA检查为确诊标准,比较CTP、3D-ASL及二者联合诊断缺血性脑卒中及评估预后的灵敏度、特异度、准确性,制作3种方法诊断缺血性脑卒中及评估预后的受试者工作特征(ROC)曲线,计算ROC曲线下面积(AUC)。结果120例疑诊缺血性脑卒中患者中,确诊74例(61.67%),排除46例(38.33%)。74例缺血性脑卒中患者中,预后良好32例(43.24%),预后较差42例(56.76%)。CTP、3D-ASL、CTP联合3D-ASL诊断缺血性脑卒中及评估预后的效能有差异,CTP联合3D-ASL检查的灵敏度(93.75%)、特异度(95.24%)、准确率(94.59%)最高(P<0.05)。CTP、3D-ASL、CTP联合3D-ASL诊断缺血性脑卒中和评估预后的AUC值分别为0.7725、0.8234、0.9143和0.7946、0.8122、0.8883,差异有统计学意义(P<0.05)。结论CTP联合3D-ASL能够显著提高诊断缺血性脑卒中和评估预后的灵敏度、特异度、准确率,临床应用价值较高。

Objective To analyze the clinical application value of CT perfusion imaging(CTP)combined with three-dimensional arterial spin labeling(3D-ASL)in the diagnosis and prognosis evaluation of ischemic stroke.Methods From December 2022 to December 2023,120 suspected ischemic stroke patients who were treated in the Sanya People’s Hospital were selected as the research subjects.All patients underwent CTP,3D-ASL,and DSA examination,and DSA examination was used as the diagnostic criteria.The sensitivity,specificity,and accuracy of CTP,3D-ASL,and the combination in diagnosing ischemic stroke and evaluating prognosis were compared.Receiver operating characteristic(ROC)curve was created for diagnosing ischemic stroke and evaluating prognosis using the three examination methods,and the area under the curve(AUC)was calculated.Results Among 120 suspected ischemic stroke patients,74(61.67%)cases were confirmed,and 46(38.33%)cases were excluded.Among 74 ischemic stroke patients,32(43.24%)had a good prognosis and 42(56.76%)had a poor prognosis.The efficacy of CTP,3D-ASL,CTP combined with 3D-ASL in diagnosis of ischemic stroke and evaluation of prognosis was different,and the sensitivity(93.75%),specificity(95.24%)and accuracy(94.59%)of CTP combined with 3D-ASL was the highest(P<0.05).The AUC value of CTP,3D-ASL,and CTP combined with 3D-ASL examination for diagnosing ischemic stroke and evaluating prognosis was 0.7725,0.8234,0.9143,and 0.7946,0.8122,0.8883,respectively,with statistical significances(P<0.05).Conclusion The combination of CTP and 3D-ASL examination can significantly improve the sensitivity,specificity,and accuracy in diagnosing ischemic stroke and evaluating prognosis,with significant clinical application value.