分子影像学杂志2025，Vol.48Issue(3)：309-314,6.DOI:10.12122/j.issn.1674-4500.2025.03.09
CT血管造影-CT灌注成像参数可提高缺血性脑卒中侧支循环评估效能
CT angiography-CT perfusion imaging parameters improve the efficacy in evaluating collateral circulation in ischemic stroke
摘要
Abstract
Objective To analyze the value of CT angiography(CTA)-CT perfusion(CTP)imaging in evaluating collateral circulation in ischemic stroke.Methods The clinical data of 150 patients with acute ischemic stroke(AIS)admitted to the hospital from October 2021 to September 2024 were retrospectively collected.According to the status of collateral circulation,patients enrolled were divided into the poor collateral circulation group(n=56)and the good collateral circulation group(n=94).Baseline data and CTA-CTP parameters of the two groups were compared.The independent risk factors for poor collateral circulation in AIS were analyzed.The receiver operating characteristic curve was plotted and the area under the curve(AUC)was used to evaluate the predictive efficacy of each risk factor for poor collateral circulation in AIS.Results The National Institutes of Health Stroke Scale(NIHSS)score upon admission and the proportion of hyperlipidemia in the poor collateral circulation group were higher than those in the good collateral circulation group(P<0.05).The core infarct volume,ischemic penumbra volume and relative mean transit time(rMTT)in the poor collateral circulation group were larger and longer than those in the good collateral circulation group.The relative cerebral blood flow(rCBF)and relative cerebral blood volume(rCBV)were smaller than those in the good collateral circulation group(P<0.05).Logistic regression analysis results showed that NIHSS score upon admission,hyperlipidemia,rCBF,rCBV,and rMTT were independent risk factors for poor collateral circulation in AIS(P<0.05).The AUCs of rCBF,rCBV and rMTT to predict poor collateral circulation in AIS were 0.737,0.797,0.784.The AUC of joint prediction using the three factors was 0.886(95%CI:0.824-0.932).The sensitivity and specificity were 94.64 and 54.26%.The AUC of joint prediction was greater than that of separate prediction(P<0.001).Conclusion There's significant correlation between NIHSS score upon admission,hyperlipidemia,rCBF,rCBV,rMTT and collateral circulation in patients with AIS.rCBF,rCBV,and rMTT can be used as predictors for poor collateral circulation,and combined use of the three can improve the accuracy of prediction.关键词
缺血性脑卒中/计算机断层扫描血管造影/计算机断层扫描灌注成像/侧支循环Key words
ischemic stroke/computed tomography angiography/computed tomography perfusion imaging/collateral circulation引用本文复制引用
陈双,陈奕,姜亦伦..CT血管造影-CT灌注成像参数可提高缺血性脑卒中侧支循环评估效能[J].分子影像学杂志,2025,48(3):309-314,6.基金项目
江苏省卫生健康委科研项目(Z2019047) （Z2019047）
