摘要
目的:观察头颅CT血管造影(CTA)与CT灌注成像(CTP)联合用于急性脑梗死出血性转化预测中的价值,提高急性脑梗死出血性转化的早期诊断率,为临床防治提供合理的影像学参考。方法:整群抽样法,回顾性分析我院2017-04~2019-04期间收治的急性脑梗死后出血性转化140例病人临床资料,并将其纳入观察组;另外回顾性分析同时期急性脑梗死未发生出血性转化的60例病人临床资料,将其纳入对照组。对比两组病人相关影像学检查情况[脑容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)],并采用受试者曲线(ROC)分析CBV、CBF、MTT各参数单独与联合预测急性脑梗死出血性转化的价值。结果:140例病人均接受CT平扫,其中未见明显异常者89例,占比63.57%,其中左颞叶缺血病灶8例,占比15.69%(8/51),右颞叶5例,占比9.80%(5/51),左基底节区5例,占比9.80%(5/51),右侧基底节9例,占比17.65%(9/51),左侧额叶12例,占比23.53%(12/51),右侧额叶10例,占比19.61%(10/51),大范围波及整个额叶与颞叶者2例,占比3.92%(2/51);140例急性脑梗死出血性转化病人经CTA检查,主要有下列几种类型:中心型30例,占比21.43%(30/140),影像学显示低密度梗死灶中间伴片状高密度出血病灶;边缘型66例,占比47.14%(66/140),影像学显示梗死灶边缘伴高密度出血灶;混合型44例,占比31.43%(31/140),影像学显示中心处于边缘均伴斑块状出血病灶;与对照组相比,观察组rCBF、rCBV均较低,MTT较高,差异有统计学意义(P<0.05);经ROC曲线得知CTP与CTA联合检测相关参数指标预测急性脑梗死曲线下面积、特异度、敏感度均较单独预测高。结论:CTP与CTA联合检测对急性脑梗死病人预测出血性转化具有较高的诊断价值,临床可将CTA与CTP联合用于筛查急性脑梗死病人出血性转化,检出率较高,利于病人良性预后。
Objective:To observe the value of cranial CT angiography(CTA)combined with CT perfusion imaging(CTP)in prediction of hemorrhagic transformation after acute cerebral infarction,to increase the early diagnostic rate of hemorrhagic transformation after acute cerebral infarction,and to provide reasonable imaging reference for clinical prevention and treatment.Methods:The cluster sampling method was used,and the clinical data of 140 patients with hemorrhagic transformation after acute cerebral infarction in the hospital from April 2017 to April 2019 were retrospectively analyzed and included in observation group;The clinical data of 60 patients without hemorrhagic transformation after acute cerebral infarction during the same period were retrospectively analyzed and included in control group.The related imaging examinations[cerebral blood volume(CBV),cerebral blood flow(CBF),mean transit time(MTT)]of two groups were compared.The receiver operating characteristic curve(ROC)was used to analyze the value of CBV,CBF and MTT alone and in combination to predict the hemorrhagic transformation after acute cerebral infarction.Results:All 140 patients underwent CT plain scan,of which89 cases had no obvious abnormalities,accounting for 63.57%,of which 8 cases were left temporal lobe ischemic lesions,accounting for 15.69%(8/51),5 cases were right temporal lobe,accounting for 9.80%(5/51),5 cases were left basal ganglia area,accounting for 9.80%(5/51),9 cases were right basal ganglia area,accounting for 17.65%(9/51),12 cases were left frontal lobe,accounting for 23.53%(12/51),10 cases were right frontal lobe,accounting for 19.61%(10/51),and 2 cases were spreading across the entire frontal and temporal lobe,accounting for 3.92%(2/51);140 patients with hemorrhagic transformation after acute cerebral infarction were examined by CTA,there were the following types:30 cases of central type,accounting for 21.43%(30/140),and the imaging showed the center of low-density infarction was accompanied by flake high-density hemorrhagic focus;Ther
作者
孙丽娜
SUN Li-na(Department of Imaging Medicine,Characteristic Medical Center of the Chinese People's Armed Police Force,Tianjin 300000 China)
出处
《内蒙古医科大学学报》
2020年第2期135-139,共5页
Journal of Inner Mongolia Medical University
关键词
急性脑梗死
出血性转化
头颅CT血管造影
CT灌注成像
预测价值
acute cerebral infarction
hemorrhagic transformation
cranial CT angiography
CT perfusion imaging
predictive value
