影像科学与光化学2025，Vol.43Issue(3)：25-33,9.DOI:10.7517/issn.1674-0475.2025.03.04
多时相CTA联合CT灌注成像对短暂性脑缺血发作患者进展为ACI的预测价值分析
Predictive Value of Multi-temporal CTA Combined with CT Perfusion Imaging in Patients with Transient Ischemic Attack Progressing to ACI
摘要
Abstract
Objective:To explore the evaluation efficacy of multi-temporal CT angiography(CTA)combined with CT perfusion imaging(CTP)in patients with transient ischemic attack(TIA)progressing to acute cerebral infarction(ACI).Methods:A retrospective analysis was conducted on 142 TIA patients admitted to our hospital from October 2020 to October 2023.They were divided into ACI group(n=35)and non ACI group(n=107)based on whether ACI occurred within 7 days after admission.Compare the general clinical data,parameters of multi-temporal CTA and CTP between two groups of patients.Using Logistic regression analysis to identify the influencing factors of ACI in TIA patients.Draw receiver operating characteristic(ROC)curve and area under the curve(AUC)to evaluate the value of CTP parameters and CTA in assessing ACI in TIA patients.Results:There was no statistically significant difference in age,gender,and whether there was coronary heart disease,smoking history,or alcohol consumption history between the two groups of patients(P＞0.05).The proportion of hypertension and diabetes in ACI group was higher than that in non ACI group,and the difference was statistically significant(P＜0.05).The degree of vascular stenosis in the ACI group was(84.61±10.46)％,which was higher than that in the non ACI group(67.39±12.55)％.The CBV(2.36±0.51)mL/100g and CBF(31.12±9.47)mL/min·100g)were lower than those in the non ACI group(3.66±0.92)mL/100g and(46.17±10.21)mL/min·100 g).The Tmax(12.67±4.75)s and MTT(6.89±2.16)s were higher than those in the non ACI group(8.44±1.94)s and(4.39±1.56)s,with statistical significance(P＜0.05).Multivariate logistic regression analysis showed that hypertension,diabetes,high Tmax,MTT and vascular stenosis were independent risk factors for the occurrence of ACI in TIA patients(P＜0.05).High CBV and CBF are both protective factors affecting the occurrence of ACI in TIA patients(P＜0.05).The ROC curve analysis results showed that the AUC of CTP parameters(Tmax,MTT,CBV,CBF)and CTA(degree of vascular stenosis)predicting the occurrence of ACI in TIA patients were 0.857,0.814,0.865,0.916,and 0.816,respectively.The AUC of combined prediction was 0.992(95％CI:0.960～0.999),with a sensitivity of 97.29％and a specificity of 95.52％.Conclusion:The combination of multi-temporal CTA and CTP exhibits high predictive value for TIA patients progressing to ACI and can serve as an important clinical assessment tool.关键词
多时相CTA/CT灌注成像/短暂性脑缺血发作/急性脑梗死Key words
multi-temporal CTA/CT perfusion imaging/transient ischemic attack/acute cerebral infarction分类
临床医学引用本文复制引用
陆凤明,姜亦伦,黄文磊,张士玉,王琪..多时相CTA联合CT灌注成像对短暂性脑缺血发作患者进展为ACI的预测价值分析[J].影像科学与光化学,2025,43(3):25-33,9.基金项目
江苏省卫生健康委科研项目(Z2019047). （Z2019047）
