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Prognostic Value of Dual-source CT Whole-Brain Perfusion Imaging in Patients with Acute Ischemic Stroke |
ZHANG Lei, WANG Jianye |
Department of CT Imaging Diagnosis, Nanyang Central Hospital, Nanyang Henan 473000 |
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Abstract 【Objective】To investigate the clinical value of dual-source CT whole brain perfusion imaging (CTP) in predicting the prognosis of patients with acute ischemic stroke (AIS).【Methods】A total of 100 patients with AIS admitted to our hospital were divided into poor prognosis group (mRS scores>2 points, n=31) and good prognosis group (mRS scores≤2 points, n=69) according to mRS Scores on the 90th day after discharge. Baseline mRS and National Institutes of Health Stroke Scale (NIHSS) scores of all patients were compared. Cerebral blood volume (CBV), time to peak (TTP), mean transit time (MTT), and time of delay(TD) were calculated by dual-source CTP. The correlation of baseline NIHSS score and mRS Score with CBV, TTP, MTT and TD was discussed, and the influence of these parameters on the 90d prognosis of AIS patients was analyzed.【Results】There was no statistical significance in the basic clinical data between the good prognosis group and the poor prognosis group (P>0.05).Compared with the good prognosis group, CBV was decreased in the poor prognosis group, but TTP, MTT and DLT were increased (P<0.05). Pearson correlation analysis showed that mRS and NIHSS scores were negatively correlated with CBV and positively correlated with TTP, MTT and TD, respectively (P<0.05).Multivariate Logistic regression showed that CBV was an independent protective factor affecting the prognosis of AIS patients within 90 days, and TTP was an independent risk factor affecting the prognosis of AIS patients within 90 days (P<0.05).【Conclusion】Dual-source CTP related parameters are potential prognostic factors in AIS patients within 90 days, in which CBV is a protective factor affecting prognosis, while TTP is a risk factor affecting prognosis. CBV, TTP, MTT and TD are significantly correlated with baseline mRS And NIHSS scores. Helps to identify high-risk patients early and guide personalized treatment.
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Received: 05 May 2024
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[1] 辛佳,赵喜庆,张利,等. 依达拉奉联合疏血通注射液治疗老年急性脑梗死的临床疗效[J].医学综述,2019,25(24):5021-5025.
[2] 赵松, 张智琴, 刘岩, 等. 全脑CT灌注成像诊断小体积急性脑梗死及其评估病灶体积与弥散加权成像的相关性[J].中国医学影像技术, 2022, 38(8): 1157-1161.
[3] 魏铭. 急性缺血性卒中血管内治疗影响筛选研究进展[J].国际神经病学神经外科学杂, 2020, 47(1): 95-98.
[4] SHAKER H, KHAN M, MULDERINK T, et al. The role of CT perfusion in defining the clinically relevant core infarction to guide thrombectomy selection in patients with acute stroke[J].Neuroimaging,2019, 29(3): 331-334.
[5] ALBERS G W,MARKS M P,KEMP S,et al. Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging[J].N Engl J Med,2018,378(8): 708-718.
[6] 刘文虎, 钟孟飞, 陈晓辉, 等. 发病24至48小时急性前循环脑梗死患者CT灌注成像指导下血管内治疗的安全性和效果分析[J].中国脑血管病杂志, 2022, 19(4): 230-237.
[7] 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.
[8] 丁帅, 周霞, 孙中武. 脑白质病变与急性脑梗死患者近期预后的关系[J].山东医药, 2016, 56(27): 47-49.
[9] VAN SWIETEN J C,KOUDSTAAL P J,VISSER M C,et al. Interobserver agreement for the assessment of handicap in stroke patients[J].Stroke,1988,19(5):604-607.
[10] 刘玉霞, 谢瑞峰, 胡延涛, 等. 多层螺旋CT全脑灌注成像对不同分级脑垂体瘤的诊断 价值分析[J].实用癌症杂志, 2021, 36(9): 1528-1532.
[11] 林澜, 王君, 马林, 等. 全脑CTP定量分析颅内动脉粥样硬化性狭窄患者血管表面渗透性[J].中国医学影像技术, 2020, 36(5): 659-664.
[12] 焦宁唤. CT血管成像与CT灌注成像对缺血性脑卒中患者脑侧支循环形成的评价[J].中国CT和MRI杂志, 2021, 19(3): 30-32.
[13] 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.
[14] 谭淦纹,曹欢,杨彦平,等. 双源CT全脑灌注成像参数对缺血性脑卒中预后的预测价值[J].海南医学,2022,33(15):1983. |
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