摘要
目的探究CT灌注成像(CTP)与磁敏感加权成像(SWI)在急性缺血性脑卒中出血性转化预测中的应用价值。方法将2021年1月~2023年12月我院收治的108例急性缺血性脑卒中患者纳入研究。所有患者均接受CTP、SWI检查,分析其影像学特征。以脑数字减影血管造影(DSA)为“金标准”,对比CTP、SWI与“金标准”结果的一致性,分析诊断效能。对比不同检查方式对出血性转化分型的检出率。结果经DSA检查,108例患者中有37例发生出血性转化,其中17例为HI-1型、10例HI-2型、6例PH-1型、4例PH-2型。CTP结果与“金标准”结果的Kappa值为0.582,一致性一般;SWI结果与“金标准”结果的Kappa值为0.609,一致性较高;联合检查结果与“金标准”结果的Kappa值为0.741,一致性较高。CTP对急性缺血性脑卒中出血性转化预测的敏感度、特异度和准确率分别为78.38%、81.69%、80.56%。SWI对急性缺血性脑卒中出血性转化预测的敏感度、特异度和准确率分别为83.78%、80.28%、81.48%。联合检查对急性缺血性脑卒中出血性转化预测的敏感度、特异度和准确率分别为89.19%、85.25%、86.73%。联合检查对HI-1型的检出率高于CTP、SWI(P<0.05),CTP、SWI对HI-1型的检出率无显著差异(P>0.05),CTP、SWI与联合检查对HI-2型、PH-1型、PH-2型的检出率无显著差异(P>0.05)。结论CTP与SWI联合检查对急性缺血性脑卒中出血性转化的预测价值较高,可有效鉴别患者的出血性转化分型,能为临床出血性转化的防治管理工作提供参考。
Objective To explore the predictive value of CT perfusion(CTP)and susceptibility weighted imaging(SWI)for hemorrhagic transformation in acute ischemic stroke.Methods A total of 108 patients with acute ischemic stroke admitted to the hospital were enrolled between January 2021 and December 2023.All underwent CTP and SWI examinations to analyze imaging characteristics.Taking digital subtraction angiography(DSA)as the golden standard,the consistency between CTP,SWI and the golden standard was compared to analyze their diagnostic efficiency.The detection rates of different classifications of hemorrhagic transformation by different examination methods were compared.Results DSA showed that in the 108 patients,there were 37 cases with hemorrhagic transformation,including 17 cases of type HI-1,10 cases of type HI-2,6 cases of type PH-1 and 4 cases of type PH-2.Kappa value between CTP and the golden standard was 0.582,showing general consistency.Kappa value between SWI and the golden standard was 0.609,showing high consistency.Kappa value between combined detection and the golden standard was 0.741,showing high consistency.The sensitivity,specificity and accuracy of CTP,SWI and combined detection for predicting hemorrhagic transformation were(78.38%,81.69%,80.56%),(83.78%,80.28%,81.48%)and(89.19%,85.25%,86.73%),respectively.The detection rate of type HI-1 by combined detection was higher than that by CTP and SWI alone(P<0.05),but there was no significant difference between CTP and SWI(P>0.05).There was no significant difference in detection rates of types HI-2,PH-1 and PH-2 among CTP,SWI and combined detection(P>0.05).Conclusion CTP combined with SWI has high predictive value for hemorrhagic transformation in patients with acute ischemic stroke,which can effectively identify different classifications of hemorrhagic transformation and provide reference for clinical prevention and management of hemorrhagic transformation.
作者
李聪聪
邹朝双
李树强
LI Cong-cong;Zou Chao-shuang;LI Shu-qiang(Qilu Hospital of Shandong University Dezhou Hospital,Dezhou 253000,Shandong Province,China;Dezhou Center for Disease Control and Prevention,Dezhou 253000,Shandong Province,China)
出处
《中国CT和MRI杂志》
2024年第8期8-10,共3页
Chinese Journal of CT and MRI
基金
山东省医药卫生科技发展计划项目(2017WS765)。
关键词
急性缺血性脑卒中
出血性转化
CT灌注成像
磁敏感成像
Acute Ischemic Stroke
Hemorrhagic Transformation
CT Perfusion
Susceptibility Weighted Imaging
