全脑CTP结合CTA对老年缺血性脑血管病的诊断价值分析

Diagnostic Value of Whole-brain CTP Combined with CTA in Elderly Patients with Ischemic Cerebrovascular Disease

目的探讨全脑CT灌注成像(CTP)结合CT血管成像(CTA)对老年缺血性脑血管病(ICVD)的诊断价值分析。方法选取2021年1月至2023年12月在本院就诊的100例老年疑似ICVD患者的临床资料进行回顾性分析,所有患者入院后均行全脑CTP和CTA检查。以DSA检查为“金标准”,统计脑CTP和CTA阳性检查结果,并分析其诊断ICVD的效能;分析CTP异常区参数[脑血流量(CBF)、达峰时间(TTP)、脑血容量(CBV)、平均通过时间(MTT)]和动脉血管狭窄程度。结果以DSA检查为“金标准”,100疑似ICVD患者,共检出阳性84例,阴性16例;脑CTP诊断阳性68例,阴性32例;CTA诊断阳性63例,阴性37例;两者联合诊断阳性87例,阴性13例,其诊断阳性的灵敏度和准确率分别为96.43%、91.00%,均高于单一诊断方式(P<0.05)。CTP异常区患侧CBF和CBV水平低于健侧,TTP和MTT水平高于健侧(P<0.05)。CTP异常区同侧狭窄程度高于对侧(P<0.05)。结论全脑CTP结合CTA诊断老年ICVD的价值较高。

Objective To explore the diagnostic value of whole-brain CT perfusion(CTP)combined with CT angiography(CTA)in elderly patients with ischemic cerebrovascular disease(ICVD).Methods A retrospective analysis was performed on the clinical data of 100 elderly patients with suspected ICVD in the hospital between January 2021 and December 2023.All patients underwent whole-brain CTP and CTA after admission.Taking DSA as the golden standard,the positive results of CTP and CTA were statistically analyzed,and their diagnostic efficiency for ICVD was analyzed.CTP parameters[cerebral blood flow(CBF),time to peak(TTP),cerebral blood volume(CBV),mean transit time(MTT)]in abnormal areas and the severity of arterial blood stenosis were analyzed.Results Taking DSA as the golden standard,in the 100 patients with suspected ICVD,there were 84 positive cases and 16 negative cases.Whole-brain CTP showed that there were 68 positive cases and 32 negative cases,CTA showed that there were 63 positive cases and 37 negative cases,and CTP combined with CTA showed that there were 87 positive cases and 13 negative cases.The sensitivity and accuracy of combined detection in the diagnosis of ICVD were 96.43%and 91.00%,higher than those of single detection(P<0.05).CBF and CBV on the affected side were lower than those on the healthy side,while TTP and MTT were higher than those on the healthy side(P<0.05).The stenosis degree on ipsilateral side of abnormal CTP area was higher than that on contralateral side(P<0.05).Conclusion Diagnostic value of whole-brain CTP combined with CTA is high for ICVD in the elderly.