| 逯瑶,曹文博,李京凯,张苗,费晓璐,卢洁.CT灌注成像低灌注强度比预测急性缺血性卒中梗死核心进展及预后[J].中国医学影像技术,2025,41(5):718~722 |
| CT灌注成像低灌注强度比预测急性缺血性卒中梗死核心进展及预后 |
| Hypoperfusion intensity ratio of CT perfusion for predicting infarct core progression and prognosis of acute ischemic stroke |
| 投稿时间：2024-09-29 修订日期：2025-03-28 |
| DOI：10.13929/j.issn.1003-3289.2025.05.005 |
| 中文关键词: 缺血性脑卒中 侧支循环 体层摄影术,X线计算机 灌注成像 |
| 英文关键词:ischemic stroke collateral circulation tomography, X-ray computed perfusion imaging |
| 基金项目:首都医科大学宣武医院"汇智"人才工程-支持计划-领军人才(HZ2021ZCLJ005)。 |
| 作者 | 单位 | E-mail | | 逯瑶 | 首都医科大学宣武医院放射与核医学科, 北京 100053
磁共振成像脑信息学北京重点实验室, 北京 100053 | | | 曹文博 | 首都医科大学宣武医院 神经外科, 北京 100053 | | | 李京凯 | 首都医科大学宣武医院放射与核医学科, 北京 100053
磁共振成像脑信息学北京重点实验室, 北京 100053 | | | 张苗 | 首都医科大学宣武医院放射与核医学科, 北京 100053
磁共振成像脑信息学北京重点实验室, 北京 100053 | | | 费晓璐 | 首都医科大学宣武医院 信息中心, 北京 100053 | | | 卢洁 | 首都医科大学宣武医院放射与核医学科, 北京 100053
磁共振成像脑信息学北京重点实验室, 北京 100053 | imaginglu@hotmail.com |
|
| 摘要点击次数: 53 |
| 全文下载次数: 15 |
| 中文摘要: |
| 目的 观察CT灌注成像(CTP)低灌注强度比(HIR)用于预测急性缺血性卒中(AIS)梗死核心进展及预后的价值。方法 回顾性分析271例AIS患者,根据梗死增长率(IGR)将其分为快速进展组(A组,n=92)与缓慢进展组(B组,n=179),比较组间临床资料、CTP参数、治疗策略及转归;绘制受试者工作特征曲线,计算曲线下面积(AUC),评估HIR预测AIS梗死核心快速进展的效能;分析HIR、IGR及治疗后90天改良Rankin量表(mRS)的中介关系。结果 组间美国国立卫生研究院卒中量表(NIHSS)评分、Alberta卒中项目早期CT评分(ASPECTS)、发病-CTP间隔时间、梗死核心体积、低灌注体积、HIR、是否静脉溶栓及治疗后90天mRS评分差异均有统计学意义(P均＜0.05)。HIR预测AIS梗死核心进展的AUC为0.856,以0.42为最佳截断值,其敏感度及特异度分别为73.91%及81.56%。IGR为HIR与治疗后90天mRS评分间的完全中介变量。结论 CTP HIR可有效预测AIS梗死核心进展;完全通过中介变量IGR影响AIS预后。 |
| 英文摘要: |
| Objective To observe the value of hypoperfusion intensity ratio (HIR) of CT perfusion (CTP) for predicting infarct core progression and prognosis of acute ischemic stroke (AIS). Methods Totally 271 AIS patients were retrospectively enrolled and divided into rapid progression group (group A, n=92) and slow progression group (group B, n=179) according to infarction growth rate (IGR). Clinical data, CTP parameters, treatment strategies and patients’ outcome were compared between groups. Receiver operating characteristic curve was drawn, the area under the curve (AUC) was calculated to evaluate the efficacy of HIR for predicting rapid progression in infarct core of AIS. The mediating relationships among HIR, IGR and modified Rankin scale (mRS) 90 days after treatment were analyzed. Results Significant differences of National Institute of Health stroke scale (NIHSS) score, Alberta stroke program early CT score (ASPECTS), also of interval time between onset and CTP, infarct core volume, hypoperfusion volume, HIR, whether intravenous thrombolysis and mRS score 90 days after treatments were found between groups (all P＜0.05). The AUC of HIR for predicting infarct core progression of AIS was 0.856, with sensitivity and specificity was 73.91% and 81.56%, respectively, when the optimal cutoff value was 0.42. IGR was a complete mediating variable between HIR and mRS score 90 days after treatment. Conclusion HIR of CTP could be used to effectively predict infarct core progression of AIS, which completely affected prognosis through mediating variable IGR. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
|
|
|
