| 滕晓萍,张久楼,王悦,张墀,鲁珊珊,施海彬.基于CT灌注自动化定量净摄水率预测急性缺血性脑卒中神经功能预后[J].中国医学影像技术,2024,40(10):1466~1470 |
| 基于CT灌注自动化定量净摄水率预测急性缺血性脑卒中神经功能预后 |
| Automated net water uptake based on CT perfusion for predicting neurological prognosis of acute ischemic stroke |
| 投稿时间：2024-05-27 修订日期：2024-07-15 |
| DOI：10.13929/j.issn.1003-3289.2024.10.003 |
| 中文关键词: 缺血性脑卒中 脑水肿 体层摄影术,X线计算机 预后 净摄水率 |
| 英文关键词:ischemic stroke brain edema tomography,X-ray computed prognosis net water uptake |
| 基金项目:国家自然科学基金青年科学基金项目(62101278)、国家自然科学基金面上项目(82171907、82271964)。 |
| 作者 | 单位 | E-mail | | 滕晓萍 | 南京医科大学第一附属医院放射科,, 江苏 南京 210029 | | | 张久楼 | 南京医科大学第一附属医院放射科,, 江苏 南京 210029 | | | 王悦 | 南京医科大学第一附属医院放射科,, 江苏 南京 210029 | | | 张墀 | 南京医科大学第一附属医院放射科,, 江苏 南京 210029 | | | 鲁珊珊 | 南京医科大学第一附属医院放射科,, 江苏 南京 210029 | | | 施海彬 | 南京医科大学第一附属医院介入放射科, 江苏 南京 210029 | shihb@vip.sina.com |
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| 中文摘要: |
| 目的 观察基于CT灌注(CTP)自动化定量净摄水率(CTP-aNWU)预测急性缺血性脑卒中(AIS)神经功能预后的价值。方法 回顾性纳入145例急性前循环大血管闭塞性卒中患者,记录入院时及随访临床资料,分析Alberta卒中项目早期CT评分-净摄水率(ASPECTS-NWU),基于平扫CT(NCCT)及CTP获得梗死核心CTP-aNWU;根据发病90天mRS评分结果将患者分为预后良好组(mRS≤2分,n=54)及预后不良组(mRS＞2分,n=91),比较组间临床及影像学资料,筛选AIS神经功能预后的独立预测因素并评估其预测效能。结果 组间年龄、入院NIHSS评分、入院ASPECTS,病灶ASPECTS-NWU、CTP-aNWU、梗死核心体积及低灌注因子差异均有统计学意义(P均＜0.05);其中,梗死核心体积 及CTP-aNWU 均为AIS神经功能预后的独立预测因素。以单一CTP-aNWU预测AIS发病90天神经功能预后的受试者工作特征曲线下面积(AUC)为0.634, 联合梗死核心体积为0.790, 后者高于前者(Z=3.500,P＜0.001)。结论 CTP-aNWU为AIS神经功能预后的独立预测因素;联合梗死核心体积有助于提升预测效能。 |
| 英文摘要: |
| Objective To observe the value of automated net water uptake (CTP-aNWU) based on CT perfusion (CTP)for predicting neurological prognosis of acute ischemic stroke (AIS). Methods A total of 145 AIS patients due to anterior circulation large vessel occlusion were retrospectively enrolled, and the clinical data at admission and follow-up were collected. Alberta stroke program early CT score net water uptake (ASPECTS-NWU) was analyzed, and CTP-aNWU of the infarct core was obtained based on CTP and non-contrast CT (NCCT). According to modified Rankin scale (mRS) score 90 days after the onset of infarction, the patients were divided into favorable prognosis group (mRS score≤2, n=54) and poor prognosis group (mRS score＞2, n=91). The clinical data and imaging data were compared between groups, and the independent predictors of neurological prognosis of AIS were evaluated, and the predictive efficacies were assessed. Results There were significant differences in age, admission NIHSS score and admission ASPECTS of patients, as well as in ASPECTS-NWU, CTP-aNWU, infarct core volume, hypoperfusion factor of the lesions between groups (all P＜0.05). The infarct core volume (OR=0.977[0.963 to 0.992], P=0.002) and CTP-aNWU (OR=0.876[0.793 to 0.969], P=0.010) were independent predictors of neurological prognosis of AIS. The area under the curve (AUC) of receiver operating characteristic curve of CTP-aNWU alone for predicting neurological prognosis of AIS patients 90 days after the onset was 0.634 (95%CI[0.550, 0.713]), which was 0.790 (95%CI[0.714, 0.853]) of CTP-aNWU combined with infarct core volume, and the latter was better than the former (Z=3.500, P＜0.001). Conclusion CTP-aNWU was an independent predictor of neurological prognosis 90 days after the onset of AIS. Combining CTP-aNWU with infarct core volume could improve the predicting efficacy. |
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