影像科学与光化学2026，Vol.44Issue(3)：115-122,8.DOI:10.7517/issn.1674-0475.2026.03.16
基于CT灌注成像和PRx建立aSAH后迟发性脑缺血发生风险Nomogram图预测模型及临床效用
Predictive Model and Clinical Utility of Nomogram Map for Risk of Delayed Cerebral Ischemia after aSAH Based on CT Perfusion Imaging and PRx
摘要
Abstract
Objective:To establish a Nomogram prediction model for the risk of delayed cerebral ischemia(DCI)after aneurysmal subarachnoid hemorrhage(aSAH)based on CT perfusion imaging and initial pressure reactivity index(PRx),and evaluate its clinical application value.Methods:This study retrospectively analyzed the data of 150 patients with aSAH admitted to our hospital from January 2022 to January 2023.These patients were divided into a model-building cohort(105 cases)and an external validation cohort(45 cases).We used the random forest algorithm to screen for key factors affecting DCI,and based on this,we constructed a Nomogram to predict DCI risk.Results:After 72 hours,factors such as cerebral blood flow(CBF),PRx,time to peak(TTP)after 72 hours,cerebral blood volume(CBV),mean transit time(MTT)after 72 hours,Glasgow Coma Scale(GCS)score,and time to peak(TTP)within 24 hours have the greatest impact on the risk of DCI.The constructed Nomogram has a C-index of 0.925,and decision curve analysis(DCA)shows that it has significant clinical net benefit.Conclusion:This study successfully established a DCI risk prediction model based on CT perfusion imaging and PRx,demonstrating good predictive performance and providing a practical tool for clinicians to identify high-risk patients with DCI at an early stage.关键词
CT灌注成像/迟发性脑缺血/动脉瘤性蛛网膜下腔出血/压力反应性指数/随机森林法/Nomogram图Key words
CT perfusion imaging/delayed cerebral ischemia/aneurysmal subarachnoid hemorrhage/pressure reactivity index/random forest method/Nomogram分类
医药卫生引用本文复制引用
刘斌,沈健,万立野,方跃,张冠男,刘莉,杜智颖..基于CT灌注成像和PRx建立aSAH后迟发性脑缺血发生风险Nomogram图预测模型及临床效用[J].影像科学与光化学,2026,44(3):115-122,8.基金项目
承德市科学技术课题支撑项目(202204A060). （202204A060）
