低剂量CT扫描的MTT、CBV、CBF及TTP值对AIS诊断及溶栓后出血转化的预测价值分析

Value of MTT,CBV,CBF and TTP values of low-dose CT scan in AIS diagnosis and Prediction of bleeding transformation after thrombolysis

目的:研究低剂量CT扫描测定局部脑血流量(Cerebral blood flow,CBF)、局部脑血容积(Regional cerebral blood volume,CBV)、血液通过组织的平均时间(Mean transit time,MTT)、达峰时间(Time to peak,TTP)对急性缺血性卒中(Acute Ischemic Stroke,AIS)患者病变的诊断及对溶栓后出血转化(Hemorrhagic transformation,HT)发生的预测效能。方法:选取2020年1月至2022年12月期间于本院治疗的120例AIS患者作为研究组。另选取同期进行头颅CT检查的其他患者120例作为对照组。所有研究组患者均采取溶栓治疗,并根据治疗后脑出血的情况,将研究组进一步分为HT组以及非HT组。两组均采用低剂量CT灌注检查,分析两组以及不同HT患者的MTT、CBV、CBF及TTP值之间的差异,研究MTT、CBV、CBF及TTP值对AIS患者病变的诊断及对溶栓后HT发生的预测效能。结果:观察组的MTT、TTP均明显高于对照组,CBV、CBF均明显低于对照组。HT组的MTT、TTP均明显高于非HT组,CBV、CBF均明显低于非HT组。通过联合诊断分析,MTT、CBV、CBF及TTP水平联合检测对AIS诊断以及HT发生的预测特异度明显高于单独检测。ROC曲线分析显示,MTT、CBV、CBF及TTP水平的对AIS诊断临界值分别为3.78,125,45.02,4.52;MTT、CBV、CBF及TTP水平对治疗后HT的诊断临界值为4.36,1.01,40.45,4.77。结论:低剂量CT扫描测定MTT、CBV、CBF及TTP值对AIS患者病变的诊断及对溶栓后HT发生具有较高预测价值。

Objective:To study the values of cerebral blood flow(CBF),regional cerebral blood volume(CBV),mean transit time(MTT)and time to peak(TTP)of low-dose CT in the diagnosis of Acute Ischemic Stroke and the prediction of hemorrhagic transformation after thrombolysis.Methods:120 AIS patients treated in our hospital from January 2020 to December 2022 were selected as the study group.Another 120 patients who underwent cranial CT examination in the same period were selected as the control group.The study group patients were treated with thrombolysis.And the study group was further divided into HT group and non-HT group according to the conditions of intracerebral hemorrhage after treatment.Low-dose CT perfusion examination was performed in both groups to analyze the differences in MTT,CBV,CBF and TTP values between the two groups and different HT patients,and to study the diagnostic efficacy of MTT,CBV,CBF and TTP values in AIS patients and the prediction of HT occurrence after thrombolysis.Results:MTT and TTP in observation group were significantly higher than those in control group,CBV and CBF were significantly lower than those in control group.MTT and TTP in HT group were significantly higher than those in non-HT group,while CBV and CBF were significantly lower than those in non-HT group.Through the combined diagnostic analysis,the prediction specificity of MTT,CBV,CBF and TTP levels for AIS diagnosis and HT occurrence was significantly higher than that of single detection.ROC curve analysis showed that the diagnostic critical values of MTT,CBV,CBF and TTP levels for AIS were 3.78,125,45.02 and 4.52,respectively.The critical values of MTT,CBV,CBF and TTP for the diagnosis of HT after treatment were 4.36,1.01,40.45,4.77.Conclusion:The values of MTT,CBV,CBF and TTP of low dose CT scan have significant value in the diagnosis of AIS and the prediction of HT after thrombolysis.