转化医学杂志2026，Vol.15Issue(4)：594-599,6.DOI:10.3639/j.issn.2095-3097.2026.04.010
缺血性脑卒中患者CT灌注成像参数与认知功能评分的关系
Association Between CT Perfusion Imaging Parameters and Cognitive Function Scores in Patients with Ischemic Stroke
摘要
Abstract
Objective To investigate the relationship between CT perfusion imaging parameters and cognitive function scores in patients with ischemic stroke.Methods The clinical data of 480 patients with acute ischemic stroke admitted to the Department of Cerebrovascular Medicine at Mianyang 404 Hospital from September 2022 to February 2025 were retrospectively analyzed.All patients underwent cranial CT perfusion imaging on admission.Based on the Montreal Cognitive Assessment(MoCA)score at the 3-month follow-up,patients were divided into a cognitive impairment group(188 cases,MoCA score 0-25)and a cognitively normal group(292 cases,MoCA score 26-30).CT perfusion imaging parameters[cerebral blood flow(CBF),cerebral blood volume(CBV),mean transit time(MTT)]in the affected hemisphere on admission,and the levels of serum neuronal injury markers[neurofilament light chain(NfL),neuron-specific enolase(NSE)]and vascular cognitive impairment markers[homocysteine(Hcy),S100β protein,brain-derived neurotrophic factor(BDNF)]at 3 months were compared between the two groups.ROC curve analysis was used to evaluate the predictive efficacy of CT perfusion imaging parameters for post-stroke cognitive impairment.Pearson correlation analysis was used to analyze the correlations between admission CT perfusion parameters and MoCA scores,serum neuronal injury markers,and vascular cognitive impairment markers in patients with cognitive impairment.Results The levels of CBF,CBV,and BDNF in the cognitive impairment group were lower than those in the cognitively normal group,while the levels of MTT,NfL,NSE,Hcy,and S100β protein were higher(P<0.05).ROC curve analysis showed that the areas under the curve for CBF,CBV,MTT,and their combination in predicting post-stroke cognitive impairment were 0.831,0.740,0.886,and 0.911,respectively(P<0.05).Pearson analysis revealed that CBF and CBV were positively correlated with MoCA score and BDNF,and negatively correlated with NfL,NSE,Hcy,and S100β protein;whereas MTT was negatively correlated with MoCA score and BDNF,and positively correlated with NfL,NSE,Hcy,and S100β protein(P<0.05).Conclusion CT perfusion parameters on admission in patients with acute ischemic stroke show significant associations with cognitive function and serum biomarkers at 3 months.Parameters such as MTT and CBF have good predictive value for post-stroke cognitive impairment.关键词
缺血性脑卒中/CT灌注成像参数/认知功能评分/ROC曲线Key words
ischemic stroke/CT perfusion imaging parameters/cognitive function scores/ROC curve引用本文复制引用
杨阳,何志明,孙雷,王元鹏,黄敏,罗军,杨芝芝..缺血性脑卒中患者CT灌注成像参数与认知功能评分的关系[J].转化医学杂志,2026,15(4):594-599,6.基金项目
四川省卫生和计划生育委员会科研课题项目(18PJ337) （18PJ337）
