多时相CTA联合CTP全脑灌注成像在缺血性脑卒中患者侧支循环影像学诊断中的应用价值

目的 探讨多时相CTA联合CTP全脑灌注成像在缺血性脑卒中患者侧支循环影像学诊断中的应用价值。方法 选择2016年3月-2019年3月本院收治的83例缺血性脑卒中患者作为观察对象,经ASPECTS侧支评估法实施侧支循环分级,将得分0～3分患者纳入侧支循环不良组,将得分4～5分者纳入侧支循环良好组; 通过NIHSS评分判定缺血性脑卒中患者预后,分析侧支循环和缺血性脑卒中患者预后的相关性。结果 侧支循环良好组患者的梗死核心区rMTT、rCBV、rTTP均高于侧支循环不良组(P<0.05); 2组患者梗死核心区rCBF比较无明显差异(P>0.05); 侧支循环良好组、侧支循环不良组患者的缺血半暗带rMTT、rCBV、rTTP比较无明显差异(P>0.05); 侧支循环良好组患者的缺血半暗带rCBF高于侧支循环不良组(P<0.05); 侧支循环良好组、侧支循环不良组患者入院时NIHSS评分比较无明显差异(P>0.05); 侧支循环良好组患者入院2周后、随访3个月后的NIHSS评分均低于侧支循环不良组(P<0.05)。结论 多时相CTA联合CTP全脑灌注成像在缺血性脑卒中患者侧支循环影像学诊断中能评估侧支循环水平,而建立良好的侧支循环能改善缺血性脑卒中患者的预后。

Application value of multi-temporal CTA combined with CTP whole brain perfusion imaging in imaging diagnosis of collateral circulation in patients with ischemic stroke

ObjectiveTo investigate the value of multi-temporal CTA combined with CTP whole brain perfusion imaging in the imaging diagnosis of collateral circulation in patients with ischemic stroke.Methods 83 cases of patients with ischemic stroke admitted to our hospital from March 2016 to March 2019 were enrolled in this study. All patients were given collateral circulation grading by ASPECTS collateral assessment. The patients with score of 0～3 points were included in the poor collateral circulation group, and the patients with score of 4～5 points were included in the good collateral circulation group. The prognosis of patients with ischemic stroke was determined by NIHSS score, and correlation between the prognosis of patients with ischemic stroke and collateral circulation was analyzed.Results The rMTT, rCBV and rTTP in the infarct core area of the patients with good collateral circulation were higher than those in the infarct core area of the patients with poor collateral circulation(P<0.05). There was no significant difference in rCBF between two groups(P>0.05). There were no significant differences in rMTT, rCBV and rTTP between two group(P>0.05). The rCBF value in the ischemic penumbra of the patients with good collateral circulation was higher than that in the schemic penumbra of the patients with poor collateral circulation(P<0.05). There was no significant difference in NIHSS scores between two groups(P>0.05). The NIHSS scores of patients with good collateral circulation after 2 months at admission and 3 months for follow-up were lower than those of patients with poor collateral circulation(P<0.05).Conclusion Multi-temporal CTA combined with CTP whole brain perfusion imaging could evaluate the level of collateral circulation in the diagnosis of collateral circulation in patients with ischemic stroke, and Establishing a good collateral circulation could significantly improve the quality of prognosis in patients with ischemic stroke.