摘要
目的探讨CT灌注成像(CTP)联合CT血管成像对短暂性脑缺血发作后继发脑梗死的预测价值。方法回顾性分析2021年8月~2023年4月期间于我院诊治的72例短暂性脑缺血患者临床资料,所有患者入院24h内均进行CTP、CT血管成像检查,根据患者短暂性脑缺血发作后7 d内继发脑梗死发生情况分为继发脑梗死组、无继发脑梗死组,对比两组CTP参数、CT血管成像特征,并展开ROC曲线分析,比较CTP、CT血管成像联合检测对短暂性脑缺血发作后继发脑梗死的预测价值。结果本研究中,72例患者短暂性脑缺血发作7 d内继发脑梗死共发生14例,发生率19.44%;继发脑梗死组脑血流容量(CBV)、脑血流流量(CBF)均低于无继发脑梗死组(P<0.05),对比剂平均通过时间(MTT)、对比剂峰值时间(TTP)均高于无继发脑梗死组(P<0.05);继发脑梗死组血管狭窄度高于无继发脑梗死组(P<0.05);经ROC曲线分析,CBV、CBF、MTT、TTP及其CTP联合检测对短暂性脑缺血发作后继发脑梗死均具有较好的预测价值[AUC分别为0.823、0.905、0.809、0.911、0.903;特异性分别为0.714、0.857、0.643、0.928、0.857;敏感度分别为0.845、0.862、0.983、0.776、0.948](P<0.05);CTP联合CT血管成像AUC为0.947,特异性0.966,敏感度0.929,提示CTP联合CT血管成像对短暂性脑缺血发作后继发脑梗死预测价值更优(P<0.05)。结论CTP与CT血管成像对短暂性脑缺血发作后继发脑梗死均具有一定预测价值,但二者联合预测价值更高,可作为临床早期预测继发脑梗死客观依据。
Objective To investigate the predictive value of CT perfusion imaging(CTP)combined with CT angiography for cerebral infarction after transient ischemic attack.Methods A retrospective analysis was conducted on the clinical data of 72 patients with transient cerebral ischemia who were treated in the hospital from August 2021 to April 2023.All patients received CTP and CT angiography within 24 h after admission.According to the occurrence of cerebral infarction within 7 d after transient ischemic attack,patients were divided into the secondary cerebral infarction group and the non-secondary cerebral infarction group.CTP parameters and CT angiography features of the two groups were compared.ROC curves were used to evaluate the predictive value of CTP and CT angiography for cerebral infarction after transient ischemic attack.Results In this study,14 patients had cerebral infarction within 7 d after transient ischemic attack,with an incidence rate of 19.44%.Cerebral blood volume(CBV)and cerebral blood flow(CBF)in the secondary cerebral infarction group were lower than those in the non-secondary cerebral infarction group(P<0.05).The mean transit time(MTT)and time to peak(TT P)of contrast agent were longer than those in the non-secondary cerebral infarction group(P<0.05).Angiostenosis in the secondary cerebral infarction was more severe than that in the non-secondary cerebral infarction group(P<0.05).ROC curves indicated that the AUC values of CBV,CBF,MTT,TT P,and their combination for predicting cerebral infarction after transient ischemic attack were 0.823,0.905,0.809,0.911,and 0.903,respectively.The specificity was 0.714,0.857,0.643,0.928,and 0.857,respectively.The sensitivity was 0.845,0.862,0.983,0.776,and 0.948,respectively(P<0.05).The AUC,specificity and sensitivity of CTP combined with CT angiography were 0.947,0.966 and 0.929,indicating higher predictive value(P<0.05).Conclusion Both CTP and CT angiography have certain predictive value for cerebral infarction after transient ischemic attack.Their combination can achieve better predictive performance and provide an objective basis for early clinical prediction of secondary cerebral infarction.
作者
张芳
孙艳霞
娄贝贝
ZHANG Fang;SUN Yan-xia;LOU Bei-bei(Department of Neurology,Luohe Second People's Hospital,Luohe 462000,Henan Province,China)
出处
《中国CT和MRI杂志》
2025年第3期22-25,共4页
Chinese Journal of CT and MRI
关键词
CT灌注成像
CT血管成像
短暂性脑缺血
继发脑梗死
CT Perfusion Imaging
CT Angiography
Transient Cerebral Ischemia
Secondary Cerebral Infarction
