CTP与DWI检查在急性脑梗死缺血半暗带中的应用价值

doi:10.3969/j.issn.1671-7171.2021.12.025

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摘要【目的】探讨全脑CT灌注成像(CTP)与弥散加权成像(DWI)检查在急性脑梗死(ACI)患者缺血半暗带(Ischemic penumbra,IP)中的应用价值。【方法】回顾性分析2019年2月至2020年7月在本院诊治的154例ACI患者,所有患者均进行CTP、DWI检查,对比不同区域的CTP脑灌注参数值、DWI参数值,采用Spearman法分析不同区域病变与DWI参数值、CTP脑灌注参数值相关性,采用ROC曲线分析各项参数值对ACI患者IP的预测价值。【结果】梗死中心区的平均扩散系数(Diffusion Coefficient Average,DCavg)值、各项异性指数(Fractional Anisotropy,FA)值、表面扩散系数(Apparent diffusion coefficient,ADC)值、脑血流量(Regional cerebral bloodflow,rCBF)低于IP区和对侧镜像区参数值(P<0.05),达峰时间(Transit time to the peak,TTP)、平均通过时间(Mean transit time,MTT)长于IP区、对侧镜像区(P<0.05),IP区的DCavg值、FA值、ADC值低于对侧镜像区参数值,TTP、MTT长于对侧镜像区,rCBF低于对侧镜像区,局部血容量(regional cerebral blood volume,rCBV)高于梗死中心区、对侧镜像区。经相关性分析,不同区域病变与TTP、MTT呈正相关(P<0.05),与rCBV、rCBF、DCavg值、FA值、ADC值呈负相关(P<0.05),ROC曲线分析显示:TTP、MTT、rCBV、rCBF、DCavg值、FA值、ADC值、七项联合早期预测ACI患者IP的AUC分别为0.622、0.778、0.941、0.955、0.943、0.944、0.952、0.997。【结论】CTP联合DWI对ACI患者IP有较高诊断效能。

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	杨迪
	周加华
	白万胜

关键词 ：脑梗死/诊断, 急性病, 磁共振成像/方法, 体层摄影术,螺旋计算机/方法

Abstract：【Objective】 To investigate the value of whole brain CT perfusion imaging (CTP) and diffusion weighted imaging (DWI) in ischemic penumbra (IP) in patients with acute cerebral infarction (ACI).【Methods】 A total of 154 patients with ACI diagnosed and treated in our hospital from February 2019 to July 2020 was retrospectively analyzed. All patients underwent CTP and DWI examination. The CTP cerebral perfusion parameter values and DWI parameter values in different regions were compared. The correlation between lesions in different regions and DWI parameter values and CTP cerebral perfusion parameter values was analyzed by Spearman method, and the predictive value of various parameter values on IP of ACI patients was analyzed by ROC curve. 【Results】The mean diffusion coefficient (DCavg), fractional anisotropy (FA), apparent diffusion coefficient (ADC) and regional cerebral blood flow (rCBF) in the infarct central area were lower than those in IP area and contralateral mirror area(P<0.05). Transit time to the peak (TTP) and mean transit time (MTT) were longer than IP area and contralateral mirror area (P<0.05), DCavg value, FA value and ADC value of IP area were lower than those of contralateral mirror area, TTP and MTT were longer than contralateral mirror area, rCBF was lower than contralateral mirror area, and regional cerebellar blood volume (rCBV) was higher than that of infarct central area and contralateral mirror area. Through correlation analysis, the lesions in different areas were positively correlated with TTP and MTT (P<0.05), and negatively correlated with rCBV, rCBF, DCavg, FA and ADC (P<0.05). ROC curve analysis showed that the AUC of TTP, MTT, rCBV, rCBF, DCavg, FA, ADC and seven combined early prediction of ischemic penumbra of acute cerebral infarction were 0.622, 0.778, 0.941, 0.955, 0.943, 0.944, 0.952 and 0.997, respectively. 【Conclusion】 CTP combined with DWI has high diagnostic efficiency for IP in patients with ACI.

Key words： Brain Infarction/DI Acute Disease Magnetic Resonance Imaging/MT Tomography, Spiral Computed/MT

收稿日期: 2021-06-03

中图分类号:

R743.33

通讯作者: *E-mail:yzhoujiahual@163.com

引用本文:

杨迪, 周加华, 白万胜. CTP与DWI检查在急性脑梗死缺血半暗带中的应用价值[J]. 医学临床研究, 2021, 38(12): 1846-1849.
YANG Di, ZHOU Jia-hua, BAI Wan-sheng. Application Value of CTP and DWI in Ischemic Penumbra of Acute Cerebral Infarction. JOURNAL OF CLINICAL RESEARCH, 2021, 38(12): 1846-1849.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2021.12.025 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2021/V38/I12/1846