ASPECTS评分及多模态CT定量分析在AIS预后预测中的应用

Application of ASPECTS Score and Multi-modal CT Quantitative Analysis in Predicting the Prognosis of AIS

目的探讨ASPECTS评分及多模态CT中各参数在急性缺血性脑卒中(AIS)预后预测的应用价值。方法收集2019年1月-2023年4月诊断为AIS并在蚌埠医学院第一附属医院就诊的患者,在治疗前均行多模态CT(包括NCCT、CTA、CTP)检查的患者93例,3个月后随访并根据改良Rankin量表评分(mRs)将患者分为预后良好组(mRs≤2)和预后不良组(mRs>2),收集两组患者的临床资料及多模态CT定量参数比较其在预测AIS中预后中有无意义。结果一般资料分析可见预后不良组患者入院基线NIHSS评分、远端侧支循环及ASPECTS评分均与预后良好组之间有一定的统计学差异(P<0.05);CT灌注定量参数分析可见预后不良组CBF较低,而MTT、Tmax、TTP较预后良好组延长,且具有统计学意义(P<0.05)。其中NIHSS、远端侧支循环及Tmax为影响AIS预后的独立危险因素。结论NIHSS、远端侧支循环、ASPECTS及多模态CT可以对AIS的预后进行评测。均具有较好的预测效能,其中Tmax及NIHSS预测效能最好。

Objective To explore the application value of ASPECTS score and various parameters in multi-modal CT in predicting the prognosis acute ischemic stroke(AIS).Methods A total of 93 patients diagnosed with AIS from January 2019 to April 2023 and treated at the First Affiliated Hospital of Bengbu Medical College who underwent multi-modal CT(including NCCT,CTA,and CTP)examinations before treatment were collected.After 3 months of follow-up,the patients were divided into a good prognosis group(mRs≤2)and a poor prognosis group(mRs>2)based on the modified Rankin scale score(mRs),Collect clinical data from two groups of patients and compare the quantitative parameters of multi-modal CT in predicting the prognosis of AIS.Results General data analysis showed that there were certain statistical differences(P<0.05)between the baseline NIHSS score,distal collateral circulation score,and ASPECTS score of patients with poor prognosis and those with good prognosis;Quantitative parameter analysis of CT perfusion showed that CBF was lower in the poor prognosis group,while MTT,Tmax,and TTP were longer than those in the good prognosis group,with statistical significance(P<0.05).NIHSS,distal collateral circulation,and Tmax were independent risk factors affecting the prognosis of AIS.Conclusion NIHSS,distal collateral circulation,ASPECTS,and multimodal CT can evaluate the prognosis of AIS.Tmax and NIHSS have the best predictive performance.