CT灌注成像联合MRA对缺血性脑卒中患者的诊断价值及预后预测价值分析

doi:10.3969/j.issn.1671-7171.2026.01.014

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Abstract 【Objective】 To explore the clinical diagnostic efficacy and prognostic predictive value of computed tomography(CT) perfusion imaging combined with magnetic resonance angiography(MRA) in patients with cerebral ischemic stroke(CIS). 【Methods】 The clinical data of 92 patients suspected of CIS admitted to our hospital from March 2023 to March 2025 were retrospectively analyzed. According to the results of digital subtraction angiography(DSA), the patients were divided into the CIS group(n=58) and the non-CIS group(n=34). The patients in the CIS group were further divided into the good prognosis group(n=21) and the poor prognosis group(n=37) based on the modified Rankin Scale(mRS) scores at discharge. The CT perfusion imaging parameters [cerebral blood flow(CBF), cerebral blood volume(CBV), mean transit time(MTT), time to peak(TTP)] and MRA findings [maximum intensity projection(MIP), multi-planar reconstruction(MPR)] of the above patients were compared. The receiver operating characteristic(ROC) curve was used to analyze the diagnostic and prognostic predictive value of CT perfusion imaging combined with MRA in patients with CIS. 【Results】 The diagnostic accuracy, sensitivity, and specificity of MRA for CIS were 93.48%, 93.10%, and 94.12%, respectively; the misdiagnosis rate was 5.88%, the missed diagnosis rate was 6.90%, the positive predictive value was 0.964, the negative predictive value was 0.889, and the Kappa value was 0.862. The levels of CBF and CBV in the CIS group were lower than those in the non-CIS group, while MTT and TTP were longer than those in the non-CIS group, with statistically significant differences(P<0.05). ROC curve analysis showed that the combined diagnosis had the highest value for CIS, with an area under the curve(AUC) [95% confidence interval(CI)] of 0.925(0.874-0.977), a sensitivity of 84.5%, and a specificity of 94.1%. Meanwhile, the combined assessment also presented the highest value for predicting the prognosis of CIS, with an AUC(95%CI) of 0.987(0.967-1.000), a sensitivity of 97.3%, and a specificity of 90.5%.【Conclusion】 CT perfusion imaging combined with MRA can significantly improve the diagnostic accuracy and prognostic predictive efficacy of ischemic stroke, which is worthy of clinical application and promotion.

Key words： Brain Ischemia Stroke Tomography, Spiral Computed Magnetic Resonance Imaging

Received: 04 July 2025

PACS:

R743.3

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	LI Hao
	TONG Shuai
	LI Haoze

Cite this article:

LI Hao,TONG Shuai,LI Haoze. Diagnostic and Prognostic Predictive Value of CT Perfusion Imaging Combined with MRA in Ischemic Stroke[J]. JOURNAL OF CLINICAL RESEARCH, 2026, 43(1): 52-55.

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2026.01.014 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2026/V43/I1/52

[1] 花纯香,蔡冬梅,居敏昊,等. CT灌注成像联合MRA对缺血性脑卒中的诊断价值[J].影像科学与光化学,2025,43(2):128-133.
[2] 王雷,石凤祥. 磁共振血管成像与多螺旋CT对缺血性脑卒中的诊断价值[J].中国CT和MRI杂志,2023,21(3):12-13.
[3] 董欣欣,吕晓波,贾永强,等. 3D-ASL与MRA在急性缺血性脑卒中患者侧支循环及预后评估中的应用[J].中国CT和MRI杂志,2023,21(11):15-17.
[4] 谢兴润,李香营. 前循环和后循环缺血性脑卒中患者的风险因素分析[J].中国急救复苏与灾害医学杂志,2023,18(5):642-646.
[5] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2018[J].中华神经科杂志,2018,51(9):666-682.
[6] 胡媛媛,马芸. 轻型非致残性脑卒中静脉溶栓疗效及预后不良的相关因素研究[J].中国临床神经科学,2024,32(2):168-176.
[7] ZHAO H L, LI C X, DUAN W X, et al. Neurological prognosis in surgically treated acute aortic dissection with brain computed tomography perfusion[J].Eur J Cardiothorac Surg,2024, 65(1): ezad437.
[8] 王欢. 高分辨率MR血管壁成像在大脑中动脉粥样硬化性狭窄中的应用[J].实用放射学杂志,2023,39(4):671-674.
[9] ZHANG H L, BAO W L, YU M Y, et al. Neuroimaging marker-CT perfusion of early neurological deterioration in patients with minor stroke and large vessel occlusion after intravenous thrombolysis[J].Curr Neurovasc Res,2024, 21(2): 198-204.
[10] CHEN K C, LIU M, ZHANG W J, et al. Efficacy of intravenous thrombolysis in patients with mild acute ischemic stroke and large vessel occlusion with different hypoperfusion volumes[J].Neurol Sci,2025,46(7): 3127-3134.
[11] 张金莉,陈旺,王贤军. 经侧支路径导丝逆行指引机械取栓术治疗后循环串联病变1例[J].中国临床神经外科杂志,2023,28(4):286-287.
[12] 金璐,郭小玲,王涛,等. 全脑CT灌注成像扫描参数对缺血性脑卒中侧支循环的评估价值[J].实用放射学杂志,2025,41(3):368-371.
[13] 于蒙蒙,任昕晨,邓雯雯,等. 全脑CT灌注联合头颈部CTA“一站式”检查在前循环急性缺血性脑卒中的诊断价值[J].中国CT和MRI杂志,2023,21(7):8-11.
[14] 熊建,屈战利,任瑜,等. CT灌注成像结合血清EPA/AA预测脑白质疏松的急性缺血性脑卒中溶栓后出血转化及短期预后的价值[J].局解手术学杂志,2025,34(1):32-37.
[15] 唐璇,张根平,陈先锋,等. CT灌注成像及血清CRP、ET-1水平与急性缺血性脑卒中患者病情程度及预后的相关性分析[J].中国CT和MRI杂志,2024,22(6):21-23.