摘要
目的探讨CT全脑灌注(CTP)结合头颈部CT血管造影术(CTA)诊断缺血性脑卒中的价值。方法抽取2017年9月至2020年1月于河南省直第三人民医院进行检查的疑似缺血性脑卒中患者80例为研究对象,均行CTP检查、CTA检查及CT平扫,分析CTP联合CTA检查对缺血性脑卒中诊断的灵敏度及特异性,评估CTP联合CTA检查在缺血性脑卒中的诊断价值。结果临床最终确诊缺血性脑卒中患者76例(95.00%),CTP结合CTA检查诊断缺血性脑卒中68例,其诊断敏感度为89.47%,特异性为75.00%,准确度为88.75%,阳性预测值为98.55%,阴性预测值为27.27%;经对比分析发现,患者健侧CBV、CBF均低于健侧,TTP、MTT均高于健侧(P<0.05);CTA检查发现80例患者存在血管狭窄共75处,其中颅内动脉狭窄25处,颈内动脉狭窄33处,颈内及颅内动脉均狭窄17处;缺血性脑卒中患者脑组织异常灌注与CBV、CBF无相关性,但与MTT呈负相关,与TTP呈正相关(P<0.05)。结论 CTP检查可对缺血性脑卒中患者脑部血流动力学进行评估,CTA检查能检测脑血管狭窄部位及程度,CTP结合CTA检查能有效诊断缺血性脑卒中,值得临床推广应用。
Objective To investigate the clinical value of whole-brain CT perfusion(CTP)combined with head and neck CT angiography(CTA)in the diagnosis of ischemic stroke.Methods A total of 80 patients with suspected ischemic stroke who were examined in Henan Provincial Third People’s Hospital from September 2017 to January 2020 were selected as the study subjects.All of them completed CTP,CTA and CT plain scan.The sensitivity and specificity of CTP combined with CTA in diagnosis of ischemic stroke were analyzed,and the diagnostic value of CTP combined with CTA in ischemic stroke was evaluated.Results 76 patients with ischemic stroke(95.00%)were finally diagnosed,68 cases of ischemic stroke were diagnosed by CTP combined with CTA,and the diagnostic sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 89.47%,75.00%,88.75%,98.55%,27.27%.Comparative analysis found that CBV and CBF on the affected sidewere significantly lower than those on the healthy side,but MTT and TTP were significantly higher than those on the healthy side(P<0.05).CTA found a total of 75 vascular stenoses in 80 patients,including 25 intracranial arterial stenoses,33 internal carotid stenoses,and 17 internal carotid and intracranial arterial stenoses.There was mo correlation between abnormal brain tissue perfusion and CBV or CBF in patients with ischemic stroke,but it was negatively correlated with MTT and positively correlated with TTP(P<0.05).Conclusions CTP can be used to evaluate cerebral hemodynamics in patients with ischemic stroke.CTA can detect the location and extent of cerebral vascular stenosis.CTP combined with CTA can effectively diagnose ischemic stroke and is worthy of clinical application.
作者
张印霞
郭山山
李楠楠
Zhang Yinxia;Guo Shanshan;Li Nannan(Department of Imaging,Henan Provincial Third People’s Hospital,Zhengzhou 450000,China)
出处
《中国实用医刊》
2021年第2期80-83,共4页
Chinese Journal of Practical Medicine
作者简介
通信作者:张印霞,Email:zhangyinxia1234567@163.com。
