摘要
目的:探讨急性脑梗死合并脑血管狭窄采用头颈计算机断层扫描血管造影(CTA)联合脑灌注成像(CTP)的诊断价值。方法:选取东营市第二人民医院2020年7月—2023年7月收治的急性脑梗死合并脑血管狭窄患者90例为研究对象,均进行头颈CTA及CTP检查,比较不同狭窄程度的CTP参数,统计头颈CTA对狭窄程度的诊断结果;绘制ROC曲线分析其预测价值。结果:DSA检出轻中度狭窄62例,重度狭窄28例。两组患者患侧脑血容量(CBV)及脑血流量(CBF)均较健侧小,达峰时间(TTP)、平均通过时间(MTT)均较健侧高;重度组健侧的CBV、CBF小于轻中度组;重度组患者患侧相较于健侧CBV、CBF下降值及TTP、MTT增大值大于轻中度患者,差异有统计学意义(P<0.05)。头颈CTA诊断轻中度狭窄59例,重度狭窄31例,准确率为85.56%(77/90)。联合诊断的AUC值为0.988,95%CI为0.964~1.000,灵敏度为96.40%,特异度为98.40%,联合诊断的灵敏度、特异度高于CTP和头颈CTA单独诊断。结论:头颈CTA联合脑CT灌注成像参数可以用于诊断急性脑梗死合并脑血管狭窄,具有较高的诊断价值。
Objective To explore the diagnostic value of head and neck computed tomography angiography(CTA)combined with cerebral perfusion imaging(CTP)for acute cerebral infarction with cerebral vascular stenosis.Methods A total of 90 patients with acute cerebral infarction complicated with cerebral vascular stenosis admitted to the Second People's Hospital of Dongying from July 2020 to July 2023 were selected as the research subjects.Head and neck CTA and CTP examinations were conducted to compare CTP parameters of different degrees of stenosis,and the diagnostic results of head and neck CTA on the degree of stenosis were statistically analyzed.Draw receiver operating characteristic(ROC)curves to analyze their predictive value.Results Digital subtraction angiography(DSA)detected 62 cases of mild to moderate stenosis and 28 cases of severe stenosis.Both groups of patients had lower cerebral blood volume(CBV)and cerebral blood flow(CBF)on the affected side compared to the healthy side,with higher peak time(TTP)and mean transit time(MTT)compared to the healthy side;The CBV and CBF of the healthy side in the severe group were lower than those in the mild to moderate group.The decrease in CBV and CBF,as well as the increase in TTP and MTT on the affected side of patients in the severe group compared to those in the healthy side,were statistically significant(P<0.05).59 cases of mild to moderate stenosis and 31 cases of severe stenosis were diagnosed by head and neck CTA,with an accuracy rate of 85.56%(77/90).The area under the curve(AUC)value of combined diagnosis was 0.988,with a 95%CI of 0.964-1.000,sensitivity of 96.40%,and specificity of 98.40%.The sensitivity and specificity of combined diagnosis were higher than those of CTP and head and neck CTA alone.Conclusion Head and neck CTA combined with cerebral CT perfusion imaging parameters can be used in the diagnosis of acute cerebral infarction complicated with cerebrovascular stenosis,which has a high diagnostic value.
作者
宋健
SONG Jian(Department of Medical Imaging,the Second People's Hospital of Dongying,Dongying,Shandong 257000,China)
出处
《影像研究与医学应用》
2024年第9期37-39,42,共4页
Journal of Imaging Research and Medical Applications
关键词
头颈CTA
脑灌注成像
急性脑梗死
脑血管狭窄
诊断价值
Head and neck CTA
Cerebral perfusion imaging
Acute cerebral infarction
Cerebrovascular stenosis
Diagnostic value
