Volume 4,Issue 9
4D CTA联合CTP成像对急性缺血性脑卒中患者预后的评估价值
目的 基于4D CTA和全脑定量CTP联合成像，分析单侧大脑中动脉中度以上狭窄患者，侧枝循环开放程度与临床预后间相关性，为临床个性化治疗脑卒中患者提供影像参考依据。方法 回顾性纳入72例首诊急性缺血性脑卒中患者，经全脑CTP与CTA证实存在一侧大脑中动脉中度以上狭窄，且灌注伪彩图存在对应异常区域，利用全脑CTP灌注原始数据重建得到动态CTA融合图像，评估患者侧枝循环状态及卒中事件发生3月后预后评分。结果 侧支循环与预后呈弱负相关（R=-0.21），但该相关性未达到统计学显著水平（p=0.079>0.05）；侧支循环与梗死核心呈弱负相关（R=-0.26，p=0.025）。年龄和梗死核心对预后具有一定预测效能，其中年龄预测预后的敏感度为52.9%、特异性为89.5%，梗死核心预测预后的敏感度为67.6%，特异性为65.8%。结论 侧枝循环不良与更严重的脑损伤相关，但直接预测预后的能力有限，侧枝循环可能通过影响梗死核心大小间接影响预后。
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