Neuroimaging diagnosis for cerebral infarction An 8-year bibliometric analysis

OBJECTIVE： To identify global research trends in neuroimaging diagnosis for cerebral infarction using a bibliometric analysis of the Web of Science. DATA RETRIEVAL： We performed a bibliometric analysis of data retrieval for neuroimaging diagnosis for cerebral infarction containing the key words ＂CT, magnetic resonance imaging, MRI, transcranial Doppler, transvaginal color Doppler, digital subtraction angiography, and cerebral infarction＂ using the Web of Science. SELECTION CRITERIA： Inclusion criteria were： （a） peer-reviewed articles on neuroimaging diagnosis for cerebral infarction which were published and indexed in the Web of Science; （b） original research articles and reviews; and （c） publication between 2004-2011. Exclusion criteria were： （a） articles that required manual searching or telephone access; and （b） corrected papers or book chapters. MAIN OUTCOME MEASURES： （1）Annual publication output; （2） distribution according to country; （3） distribution according to institution; （4） top cited publications; （5） distribution according to journals; and （6） comparison of study results on neuroimaging diagnosis for cerebral infarction. RESULTS： Imaging has become the predominant method used in diagnosing cerebral infarction. The most frequently used clinical imaging methods were digital subtraction angiography, CT, MRI, and transcranial color Doppler examination. Digital subtraction angiography is used as the gold standard. However, it is a costly and time-consuming invasive diagnosis that requires some radiation exposure, and is poorly accepted by patients. As such, it is mostly adopted in interventional therapy in the clinic. CT is now accepted as a rapid, simple, and reliable non-invasive method for use in diagnosis of cerebrovascular disease and preoperative appraisal. Ultrasonic Doppler can be used to reflect the hardness of the vascular wall and the nature of the plaque more clearly than CT and MRI. CONCLUSION： At present, there is no unified standard of classification of cerebral infarction imaging. Detection of clinical super-acute cerebral infarction remains controversial due to its changes on imaging, lack of specificity, and its similarity to a space-occupying lesion. Neuroimaging diagnosis for cerebral infarction remains a highly active area of research and development.

Correspondence of CT perfusion imaging to pathological manifestations in rabbit models of hyperacute cerebral infarction

BACKGROUND： Could the infarction be diagnosed quickly and accurately at the acute stage by CT perfusion imaging （CTPI） technology？ Whether the images of CTPI will correspond with the pathological changes or not？ All the questions need to be solved by experimental and clinical studies. OBJECTIVE： To reveal the rules of perfusion map changes and guide the early diagnosis of hyperacute cerebral infarction by analyzing the correlation of CTPI with pathological manifestations for hyperacute cerebral infarction. DESIGN： A randomized controlled animal experiment. SETTING： Experimental Center of Medical Radiology, Longgang Central Hospital of Shenzhen City. MATERIALS： Forty-two adult New Zealand rabbits of （2.6±0.5） kg, either male or female, were randomly divided into experimental group （n =36） and control group （n =6）. Six rabbits in the experimental group were observed after ischemia for 0.5, 1, 2, 3, 4 and 6 hours respectively, and 1 rabbit in the control group was observed at each corresponding time point. METHODS： The experiments were carried out in the Experimental Center of Medical Radiology, Longgang Central Hospital of Shenzhen City from March 2003 to July 2004. Rabbit models of cerebral infarction were established by modified O＇Brein method. （1） The rabbits in the experimental group were scanned at 0.5, 1, 2, 3, 4 and 6 hours after ischemia respectively. The dynamic CT scan slice was 13 mm from the anterior edge of the frontal cortex, and six fake color functional images were obtained, including cerebral blood flow map （CBF map）, cerebral blood volume map （CBV map）, peak to enhancement map （PE map）, flow without vessels map, time to peak map （TP map）, time to start map （TS map）. The manifestations and changes of the functional maps in different interval were observed. （2） Bilateral symmetric ranges of interest （ROI） were drawn separately on the CBF map, CBV map, TP map and TS map. The blood flow parameters of focal and contralateral cerebral tissues could be obtained to calculate relative cerebral blood flow （rCBF, rCBF=focal CBF/contralateral CBF）, relative cerebral blood volume （rCBV, rCBV= focal CBV/contralateral CBV）, a relative time to peak （rTP, rTP= focal TP - contralateral TP）, a relative time to start （rTS, rTS= focal TP - contralateral TP）. （3） The perfusion maps were input into AutoCAD software. The percents of ischemic cores and peri-ischemic areas accounting for contralateral cerebral hemisphere were calculated. （4） The animals were anesthetized and killed, then the cerebellum and low brain stem were taken out. The brain tissues were cut on coronal plane at 14 mm from the anterior edge of the frontal cortex, a 2-mm piece anterior to the incision, and a 3-mm piece posterior to the incision. The anterior piece was fixed, stained and observed. A 1-mm slice was cut from the front of the posterior piece tissues as electron microscope sample, the remnant was fixed and then taken out, and the location and size of stained ＂white＂ areas were observed as the reference for electron microscope sample. （5） The correlation between CTPI and pathological manifestations was observed. MAIN OUTCOME MEASURES： （1） Laws of time and spatial changes of ischemic areas; （2） Pathological changes of the ischemic tissues; （3） Correspondency between CTPI and pathological manifestations. RESULTS： （1） Laws of time and spatial changes of ischemic areas： Relative ischemic-core areas were consistent in each perfusion map, increased incessantly along with the ischemic times. Relative peri-ischemic areas were inconsistent in each perfusion map, on CBF map from 1 to 6 hours after ischemia, the area of ischemic core increased from （1.503±0.523）% to （7.125± 1.054）%, the ascending trend occurred. But the peri-ischemic areas showed a descending trend on CBF map, the areas decreased from （8.960±0.719）% to （5.445 ± 0.884）% from 0.5 to 6 hours; The relative areas were the largest one on TP maps, the average value was （32.796±3.029）% at 0.5 hour after ischemia happening （60.540±1.683）% at 6 hours. The trend of ischemic areas was increased. No obvious change was observed on TS maps. （2） Pathological changes of the ischemic tissues： Under light microscope, there was no obvious change at 0.5- 2 hours after ischemia, edema at 3 hours, karyopycnosis at 4 hours and eosinophilous changes at 6 hours; Under electron microscope, there was edema in ischemic cores within 4 hours after ischemia, whereas karyopycnosis or structure vanished after 4 hours; Edema was observed in peri-ischemic areas. （3） Correlation between CTPI and pathological manifestations： On CTPI maps, the ischemic core was blue on CBF and CBV maps, black on TP and TS maps. Along with the ischemic times, the rCBF and rCBV decreased, whereas the rTP and rTS prolonged. Hemodynamic parameters were not significantly different within 2 hours of ischemia and 2 hours after ischemia. The rTP and rTS became 0 after 1 and 2 hours respectively. On CTPI maps the peri-ischemic area was red on CBF and CBV maps, red and yellow on TS maps, red on TP maps. Along with the ischemic times, the rCBF decreased, and the lowest level was always at about 20%, whereas the rTP and rTS prolonged. CONCLUSION： （1） CTPI manifestations corresponded well with pathological findings, and it is a sensitive, stable and reliable technique to diagnose hyperacute cerebral infarction. （2） TP map was more sensitive than CBF map and TS map in exhibiting the peri-ischemic areas, thus TP maps could be a good choice for observing peri-ischemic areas.

COMPARISON OF EFFECTS OF ACUPUNCTURE ON CEREBRAL INFARCTION IN DIFFERENT PARTS

92 cases of acute cerebral infarction confirmed by CT were assigned to cerebral hemi sphere surface infarction group and cerebral hemisphere deep infarction gioup according to infarction parts. The two groups were further divided randomly into acupuncture groups and simp1e drug control groups, respectively, i. e, surface infarction acupuncture group, surface infarction control group, deep infarction acupuncture group and deep infarction control group. Changes of nervous function be fore and after treatment were investigated in the 4 groups. Results indicated that acupuncture treatment had a definite therapeutic effect on acute cerebral infarction, but it had different effects on cereral infarction of different parts, that is, the therapeutic effect of acupuncture on cerebral surface infarction was superi or to that on deep infarction. It is suggested that effects of acupuncture are related closely with the in farction part.

Right Hemisphere Cerebral Infarction Due to Air Embolism from Percutaneous Lung Biopsy: A Case Report

Percutaneous transthoracic needle biopsy is a common procedure in interventional radiology. Systemic arterial air embolism causing cerebral infarction is a rare but much feared complication of percutaneous lung biopsy. We present a comprehensive review of iatrogenic air embolism post-lung biopsy, a complication that is often sub optimally managed. Patho-physiology, clinical features, and risk factors and management are reviewed.

Evaluation of multislice computed tomographic perfusion imaging and computed tomographic angiography on traumatic cerebral infarction

Objective： To evaluate the application value of multislice computed tomographic perfusion imaging （MSCTPI） and multislice computed tomographic angiography （MSCTA） on traumatic cerebral infarction. Methods： MSCTA was performed on 10 patients who were initiailly diagnosed as traumatic cerebral infarction by normal conventional computed tomography （NCCT）, among whom, 3 patients were examined by MSCTPI simultaneously. Reconstructed images of the intracranial artery were made with techniques of maximum intensity projection （MIP） and volume rendering （VR） from MSCTA scanning data. Then the graph of function of four parameters, regional cerebral blood flow （rCBF）, regional cerebral blood volume （rCBV）, mean transit time （MTT）, and time to peak （TTP）, acquired by the perfusing analysis software was obtained. Results： Among the 10 patients with traumatic cerebral infarction, 6 showed complex type on NCCT, which depicted abnormality on MSCTA, and 4 showed simple type on NCCT, which had negative results on MSCTA. Among the 4 patients with abnormal great vessels, 2 suffered from stenosis or occlusion of the middle cerebral artery, 1 from spasm of the anterior cerebral artery, and 1 from spasm of the vertebral-basal artery. The image of MSCTPI of 1 patient with massive cerebral infarction on the right cerebral hemisphere confirmed by CT was smaller than those of the other patients, which showed occlusion of the ipsilateral middle cerebral artery on MSCTA, Among the 6 patients whose MSCTA showed no abnormality, 4 showed simple infarction and 2 showed complex infarction. The infarction focus of 5 patients occurred in the basal ganglia and 1 in the splenium of corpus callosum. Among the 2 cases of small cerebral infarction volume on NCCT, one was normal, the other showed hypoperfusion on MSCTPI and was normal on MSCTA. Conclusion： The combination of MSCTPI and MSCTA is very useful for evaluating the change of intracranial artery in ischemic regions and assessing the cerebral hemodynamic information of traumatic cerebral infarction.

Regional cerebral blood flow imaging assessment of brain function reconstruction in elderly hemiplegia patients by body weight support treadmill training

The mechanism underlying body weight support treadmill training in elderly hemiplegic stroke patients is largely unknown. This study aimed to elucidate the changes of cortical blood flow in seven elderly patients with post-stroke hemiplegia before and after body weight support treadmill training by semi-quantitative analysis of regional cerebral blood flow assessed by single photon emission computed tomography. Body weight support treadmill training for 6 months was effective in improving cerebral blood flow and promoting the walking speed and balance recovery in elderly patients with post-stroke hemiplegia.

CT Perfusion Imaging Predicts One-Month Outcome in Patients with Acute Spontaneous Hypertensive Intracerebral Hemorrhage

Purpose: Little is known about the relationship between perihematomal perfusion parameters in acute spontaneous hypertensive intracerebral hemorrhage patients and recent outcome. The purpose of this study was to evaluate the relationship between the perfusion parameters of the perihematomal brain tissue and the recent prognosis of patients with acute spontaneous hypertensive intracerebral hemorrhage (shICH) using CT perfusion (CTP) imaging. Methods: Twenty-six patients with clinical and CT diagnosed supratentorial shICH received CTP scanning within 8 - 19 h after symptom onset. At the maximum levels of the hematoma, cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) of perihematomal area (isodense within 1cm rim of perilesion area on plain CT) and contralateral mirrored hemisphere were measured, and rCBF, rCBV, rMTT were calculated (ipsilateral/contralateral). The one-month follow-up in accordance with daily living table (Barthel index, BI) by telephone was recorded. Results: The CBV, CBF, and MTT values of perihematoma area were (1.61 ± 1.53) ml·100 g-1, (16.48 ± 12.58) ml·100 g-1·min-1, and (9.12 ± 2.57) s, respectively. (For more information,please refer to the PDF)

Therapeutic Effects of Tongxinluo Capsule(通心络胶囊) on Patients with Acute Small Oerebral Infarction and Its Influence on SPECT Brain Periusion Image

Objective: To investigate the influence of Tongxinluo capsule (TXL,通心络胶囊) on regional cerebral blood flow (rCBF) with 99mTc-ECD single photon emission computed tomography (SPECT) brain perfusion imaging, and to observe the therapeutic effects of TXL on acute small cerebral infarction (ASCI). Methods: Thirty-four patients with ASCI were enrolled and randomly divided into two groups: the control group (n = 17) was treated with the conventional treatment, i.e. 1. Og of Citicoline added into 300 ml normal saline for intravenous dripping daily for 2 weeks and 0. 8 g of Piracetam taken three times a day orally for 4 weeks, and the treatment group (n = 17) was treated additionally with 4 TXL capsules three times a day for 4 weeks besides the conventional treatment. The 99mTc-ECD SPECT brain perfusion imaging was performed before and after treatment to observe the change of rCBF, and the neurological deficit was evaluated by Edinburgh-Scandinavia stroke scale (SSS) scores and Barthel index (Bl) at the same time. Results: After treatment, the rCBF in the treatment group was significantly improved (P<0. 01), while that in the control group remained unchanged, with the comparison of the rCBF in the two groups after treatment showing significant difference (P<0.01). In addition, the SSS score was significantly lower and Bl significantly higher in the treatment group than those in the control group respectively after treatment. Conclusion: TXL could effectively improve rCBF and lessen the neurological deficit symptoms in patients with ASCI.

多模式CT指导下动脉溶栓对急性致残性非大血管脑梗死患者氧化应激、炎症反应及神经功能的影响

目的探讨多模式CT指导下动脉溶栓在急性致残性非大血管脑梗死患者治疗中的应用价值。方法回顾性分析2022年1月至2023年12月收治的急性致残性非大血管脑梗死患者80例的临床资料,根据治疗方案分为观察组和对照组各40例。观察组行多模式CT指导下应用动脉溶栓,对照组行静脉溶栓。比较2组临床疗效、溶栓前后神经功能损伤程度(NIHSS评分)、氧化应激反应指标[超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、丙二醛(MDA)]、炎症反应指标[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)]、血管再通情况及不良事件发生率。结果2组总有效率比较差异无统计学意义(P>0.05);溶栓后2 h、24 h、7 d及30 d,观察组NIHSS评分低于对照组(P<0.05);溶栓后7 d及30 d,观察组SOD、GSH-Px水平高于对照组,MDA、IL-6、hs-CRP、TNF-α水平低于对照组(P<0.01);2组血管再通率、不良事件发生率比较差异无统计学意义(P>0.05)。结论多模式CT指导下动脉溶栓与静脉溶栓效果及安全性相当,但动脉溶栓能减轻炎症反应及氧化应激损伤,改善神经功能。

老年小量脑出血患者误诊脑梗死临床分析

目的总结老年小量脑出血误诊脑梗死的原因及其防范措施。方法分析2021年1月至2023年1月收治的早期误诊为脑梗死的老年小量脑出血10例病案资料。结果本组男7例,女3例;年龄61~72岁;均有高血压史;急性发病,静态(睡眠、休息)发病3例,动态发病7例;发病时10例血压均升高;9例出现头晕,2例轻微头痛,6例言语不利,3例轻微中枢性面、舌瘫,偏瘫7例,未出现意识障碍或呕吐症状。于当地乡镇卫生院或诊所初步诊断为脑梗死。给予对症治疗,临床症状无明显好转或加重,遂转我院。全面分析病情后行头颅CT检查发现基底节区出血5例,丘脑出血4例,颞叶出血1例,中线结构居中,侧脑室受压变窄4例;出血量2.9~7.3 mL,平均5.1 mL。均确诊为小量脑出血。误诊时间4~5 d。确诊后10例给予控制血压、脱水、维持水电解质平衡,以及营养脑神经、活血化瘀等药物治疗,3~4周后症状体征基本恢复正常,复查头颅CT示血肿均已明显吸收,预后良好。结论老年小量脑出血因老年人生理病理特点,导致早期无典型颅内压升高、脑膜刺激征表现,加之出血量少,无显著占位效应,使得未行CT等影像学检查前易考虑为脑梗死。加强接诊医生对老年小量脑出血的认识,提高警惕性,重视血压升高表现及发病时状态,及早行CT等影像学检查,可提高本病早期确诊率。

彩色多期CT血管成像对脑大、中动脉闭塞性脑梗死的诊断价值

目的探讨彩色多期CT血管成像(ColorViz mCTA)对大、中动脉闭塞性脑梗死的诊断价值。方法选取本院急性缺血性脑卒中患者306例,均完成多期CTA及MRI-DWI检查。多期CTA血管信息由FastStroke软件汇总。对比ColorViz mCTA对于大、小梗死灶的检出差异性,分析ColorViz mCTA与区别大、小病灶之间的相关性,利用ROC曲线评价ColorViz mCTA对区分大、小急性脑梗塞灶的诊断价值。结果共检出323个病灶,其中大、中动脉闭塞性梗死灶共190个,小动脉闭塞性脑梗死灶133个。病灶越大,ColorViz mCTA检出率越高(P<0.001),并且ColorViz mCTA与病灶大小有显著相关性(r=0.749,P<0.001);ColorViz mCTA区分大、小病灶曲线下面积(AUC)为0.933(P<0.001),当病灶面积等于2.53 cm2时,ColorViz mCTA具有最大诊断效能,敏感度为91.1%,特异度为86.1%。结论利用ColorViz mCTA可对脑大、中动脉闭塞性脑梗死针对性诊断。

DWI-ASPECTS评分联合血清Hcy、LDL-C、Lp-PLA2对急性脑梗死静脉溶栓患者预后不良的预测价值

目的分析弥散加权成像-阿尔伯塔卒中项目早期计算机断层扫描(DWI-ASPECTS)评分联合血清同型半胱氨酸(Hcy)、低密度脂蛋白胆固醇(LDL-C)、脂蛋白磷脂酶A2(Lp-PLA2)对急性脑梗死(ACI)静脉溶栓患者预后不良的预测价值。方法回顾性分析2021年3月至2023年9月山东大学齐鲁医院德州医院收治的102例ACI患者的临床资料,静脉溶栓3个月后以改良Rankin量表(mRS)评估患者预后,根据mRS评分将患者分为预后良好组(mRS评分≤2分)与预后不良组(mRS评分>2分)。比较两组基线资料及血清Hcy、LDL-C、Lp-PLA2水平及DWI-ASPECTS评分。绘制受试者工作特征(ROC)曲线分析DWI-ASPECTS评分联合血清Hcy、LDL-C、Lp-PLA2对ACI静脉溶栓患者预后不良的预测价值。结果预后不良组有35例患者,预后良好组有67例患者。预后不良组美国国立卫生研究院卒中量表(NIHSS)评分及Hcy、LDL-C、Lp-PLA2水平高于预后良好组,DWI-ASPECTS评分低于预后良好组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,DWI-ASPECTS评分联合Hcy、LDL-C、Lp-PLA2评估ACI静脉溶栓患者预后不良的曲线下面积(AUC)大于DWI-ASPECTS评分、Hcy、LDL-C、Lp-PLA2单独预测的AUC(Z=3.548、3.316、3.996、4.009,P<0.05)。结论DWI-ASPECTS评分及血清Hcy、LDL-C、Lp-PLA2均对ACI静脉溶栓患者预后不良具有一定的预测价值,且其联合检测可提高预测价值。

CTA和DSA诊断缺血性脑血管病临床应用评价

目的:探讨CTA诊断缺血性脑血管疾病的作用。方法:用CTA检查缺血性脑血管患者,与DSA检查结果相比较。结果:检查动脉共198条,两种检查结果一致的动脉195条,诊断不符合动脉3条:结论:CTA诊断脑缺血性疾病有相当高的准确性和可重复性。充分利用CTA各种分析诊断方法,可完全替代DSA检查。

DSA介入下制作犬脑出血模型的研究

目的:探讨建立与人类脑出血(intra-cerebral hemorrhage,ICH)相似、稳定可靠、重复性好的犬ICH模型的可行性.方法:选择健康家犬45只,经股动脉插管DSA下,导丝经导管进入并刺破大脑中动脉.制作ICH模型,以成功后2h脑CT检查结果确定血肿部位并计算血肿体积,观察24h内血肿体积变化及犬死亡情况.结果:45只犬脑出血部位均在基底节区或临近颞叶;血肿体积2.1～4ml者明显多于4.1～5ml、1.5～2ml及≥5ml者(P均＜0.01);体积为4.1～5ml者明显多于1.5～2ml及≥5ml者(P均＜0.01);血肿≤4ml破入脑室者明显少于≥4.1ml者(P＜0.01),前者24h无1只死亡,明显少于后者(P＜0.01).结论:DSA介入下制作犬ICH模型,血肿部位合适、大小适中、模型稳定、破入脑室及死亡率均低,更接近于人类ICH.

超急性动脉闭塞性脑梗塞CT和DSA对比检查研究

目的 :了解CT和DSA各自对超急性脑动脉闭塞性脑梗塞的诊断价值及相互之间在影像学方面的关联。方法 :10例患者 ,临床上均因突发性失语、一侧肢体偏瘫、无明显神志障碍、且在发病 6h内就诊。所有患者均经神经内科医生检查 ,疑诊为脑梗塞后先行头部CT扫描 ,再行DSA检查 ,并在诊断明确的基础上进行动脉介入溶栓治疗。结果 :2例 4级脑动脉分支闭塞患者的CT和DSA检查结果基本相符 ;5例脑动脉主干闭塞的患者尽管CT发现脑梗塞灶 ,但其范围明显小于动脉的供血范围 ;1例DSA见动脉闭塞 ,但CT未见低密度改变 ;1例DSA见动脉闭塞 ,CT仅见局部脑肿胀改变 ;1例患者CT和DSA发病 6h内检查均为阴性 ,2 4h后CT复查见脑梗塞灶。结论 :DSA在显示脑动脉闭塞或狭窄方面具有较高的敏感性 ,CT只是在缺血脑组织的病理变化发展到一定阶段时才能检测出来。尽管如此 ,我们仍然认为CT是诊断急性缺血性脑梗塞的首选检查方法。DSA只是在进行动脉内介入溶栓治疗时予以使用。

CT与MRI对急性脑梗死患者脑血管及灌注的诊断效能对照研究

目的探究计算机断层扫描(CT)、磁共振成像(MRI)对急性脑梗死患者脑血管及脑灌注的诊断效能差异。方法采用前瞻性研究方式,选取2020年2月—2022年4月荣县人民医院收入的76例急性脑梗死患者为研究对象。所有患者均接受了CT血管成像(CTA)、CT灌注(CTP)、MRI检查[含高分辨Cube T1WI、多延迟伪连续动脉自旋标记(pCASL)]以及数字减影血管造影(DSA)检查。以DSA检查结果为金标准,分析MRI相关检查、CTA对急性脑梗死患者脑血管狭窄程度诊断的差异性,以Kappa值表达CTA、MRI与DSA诊断结果的一致性。由多延迟pCASL检查得到脑血流量(CBF),由CTP检查得到CBF、平均通过时间(MTT),于体素水平基础上比较在灰质、白质、全脑区域上多延迟pCASL、CTP灌注参数间Pearson相关系数差异。结果以DSA结果为金标准,76例急性脑梗死患者在通过MRI、CT、DSA检查后有69例相同患者被发现存在不同程度狭窄。与DSA结果诊断结果相比,Cube T1WI诊断中4例患者狭窄程度偏高,1例患者偏低;CTA诊断中5例患者狭窄程度偏高,3例患者偏低。三种诊断方式结果比较,Kappa值均处于0.800~1.000范围内,具有高度一致性(P<0.05)。PLD为1500 ms、1800 ms、2500 ms时pCASL的CBF值分别为(25.63±12.17)mL/(100 g·min)、(39.78±17.53)mL/(100 g·min)、(32.64±15.12)mL/(100 g·min)。pCASL所得CBF值与CTP所得CBF值、MTT值在PLD为1500 ms、1800 ms、2500 ms时均呈显著正相关(P<0.05)。结论在急性脑梗死患者脑血管、脑灌注评估中CT、MRI均有较好诊断效能,但MRI检查中的Cube T1WI与DSA脑血管诊断一致性更高,多延迟pCASL灌注安全性更好。

磁共振成像与CT在诊断老年多发性脑梗死中的临床价值探讨

目的 探讨磁共振成像(MRI)、CT检查技术在诊断老年多发性脑梗死中的临床价值。方法 采用随机抽样法抽取我院2020年1月至2022年12月就诊的130例老年多发性脑梗死患者,其中65例采用MRI检查,另65例采用CT检查。比较MRI与CT对不同时间脑梗死的检出率、不同脑梗死部位的检出情况以及对病灶个数、病灶大小、检查时间以及发病-检查时间的影响。结果 MRI检查在<24 h、24~72 h、>72 h的检出率高于CT检查(P<0.05);MRI检查在基底节区、丘脑、小脑、侧脑室旁的检出率高于CT检查(P<0.05);MRI检查在病灶个数、病灶大小、多于CT检查,而发病-检查时间短于CT检查(P<0.05)。结论 相较于CT检查技术,MRI检查技术在诊断老年多发性脑梗死中的临床价值更高,在不同时间脑梗死和不同脑梗死部位的检出情况具有较高的检出率,且可缩发病-检查时间。

CT、MRI联合检查在急性多发性脑梗死诊断中的效能

目的:分析计算机断层扫描(CT)、磁共振成像(MRI)联合检查在多发性急性脑梗死(ACI)诊断中的效能。方法:选取2021年8月至2023年8月该院收治的85例疑似ACI患者进行前瞻性研究,所有患者均行CT、MRI检查,并以数字减影血管造影(DSA)为金标准,比较CT、MRI单项及联合检查诊断ACI的结果、效能,并采用Kappa检验分析CT、MRI单项及联合检查与DSA检查的一致性。结果:金标准检查结果显示,85例疑似ACI患者中,阳性60例,阴性25例;CT检查结果显示,阳性55例,阴性30例;MRI检查结果显示,阳性56例,阴性29例;CT、MRI联合检查结果显示,阳性59例,阴性26例;CT、MRI联合检查诊断ACI的灵敏度、准确度均高于CT、MRI单项检查,差异有统计学意义(P<0.05);Kappa检验结果显示,CT检查与金标准检查诊断ACI的一致性尚可;MRI检查诊断与金标准检查诊断ACI的一致性尚可;联合检查诊断与金标准检查诊断ACI的一致性良好。结论:CT、MRI联合检查诊断ACI的效能高于二者单项检查。

头颅CT联合MRI-DWI对急性脑梗死的评估分析

目的探讨头颅CT联合MRI-DWI对急性脑梗死的评估价值。方法选取150例就诊时症状符合急性脑梗死患者,所有患者均接受数字减影血管造影(DSA)、电子计算机X线断层扫描(CT)、磁共振成像弥散加权成像(MRI-DWI),以DSA作为金标准,根据金标准诊断结果将患者分为梗死组、其他疾病组,对比两组患者的头颅CT、MRI-DWI影像学参数,分析其对急性脑梗死的评估效能。结果150例疑似急性脑梗死患者经DSA确诊128例,占85.33%。相较于其他疾病组,梗死组的CT值、ADC值与DCavg值较低,差异有统计学意义(P<0.05)。绘制受试者操作特征曲线(ROC),结果显示,CT值、ADC值评估急性脑梗死有一定效能,且联合评估效能较高。以DSA作为金标准,经ROC得到各参数评估急性脑梗死的最佳阈值,根据阈值判定评估结果。结果显示,头颅CT检查对急性脑梗死检出率为79.69%(102/128),MRI-DWI检出率为86.72%(111/128),联合检出率为94.53%(121/128),联合检出率更高,且联合检查的敏感度高于单独检查,其准确率、阴性预测值高于头颅CT检查,差异有统计学意义(P<0.05),联合检查与金标准的一致性更强。结论头颅CT联合MRI-DWI可有效评估急性脑梗死,且与金标准有较好的一致性,有一定应用价值。

磁共振与计算机断层扫描检查对老年多发性脑梗死患者的诊断价值分析

目的比较磁共振与计算机断层扫描检查对老年多发性脑梗死不同发病时间、不同病灶部位及不同病灶大小的检出率及诊断效能。方法选择155例疑似老年多发性脑梗死患者作为研究对象,所有患者均进行磁共振检查和计算机断层扫描检查。以脑梗死临床指南确诊为“金标准”,共有111例患者确诊为多发性脑梗死,比较两种检查方法对不同发病时间、不同病灶部位、不同病灶直径患者的检出情况;比较两种检查方法的病灶检出数、检出病灶直径;比较两种检查方法对老年多发性脑梗死的诊断效能(灵敏度、特异度、准确度)。结果磁共振检查对发病时间<6 h、6~23 h、24~71 h患者的检出率及总检出率分别为52.63%、92.59%、95.35%、88.29%,均明显高于计算机断层扫描检查的15.79%、37.04%、58.14%、53.15%,差异具有统计学意义(P<0.05)。磁共振检查对基底节、额叶、丘脑、顶叶、脑干病灶患者的检出率分别为71.17%、57.66%、43.24%、37.84%、9.91%,明显高于计算机断层扫描检查的49.55%、32.43%、24.32%、20.72%、2.70%,差异具有统计学意义(P<0.05)。磁共振检查对病灶直径<2 mm、病灶直径≥2 mm患者的检出率分别为73.33%、93.83%,均明显高于计算机断层扫描检查的30.00%、61.73%,差异具有统计学意义(P<0.05)。磁共振检查的病灶检出数为(2.90±0.42)个/人,明显多于计算机断层扫描检查的(1.89±0.30)个/人,差异具有统计学意义(P<0.05)。磁共振检查共检出病灶322个,检出病灶直径为(7.84±1.42)mm;计算机断层扫描检查共检出病灶210个,检出病灶直径为(10.66±2.06)mm,磁共振检查的检出病灶直径明显小于计算机断层扫描检查,差异具有统计学意义(P<0.05)。磁共振检查诊断老年多发性脑梗死的灵敏度为88.29%、特异度为93.18%、准确度为89.68%,明显高于计算机断层扫描检查的53.15%、75.00%、59.35%,差异具有统计学意义(P<0.05)。结论磁共振与计算机断层扫描检查均为诊断老年多发性脑梗死的重要检查方法,但磁共振检查对多发性脑梗死微小病灶、病灶定位(基底节区、额叶、丘脑、顶叶、脑干)的诊断价值更好,临床诊断效能也更高。