现代仪器与医疗

CT灌注成像参数对急性脑梗死患者侧支循环及静脉溶栓后功能结局的预测价值

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刘娟

现代仪器与医疗 | 临床研究 2025,31(3): 73-77

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现代仪器与医疗 |临床研究 2025 , 31 (3) : 73 -77

CT灌注成像参数对急性脑梗死患者侧支循环及静脉溶栓后功能结局的预测价值

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刘娟

作者信息

上海杨思医院神经内科，上海　200126

作者简介:

刘娟，女，本科，主治医师，研究方向：脑血管疾病诊断与治疗

The predictive value of CT perfusion imaging parameters for collateral circulation and functional outcomes after intravenous thrombolysis in patients with acute cerebral infarction

Juan Liu

Affiliations

Department of Oncology, Shanghai Yangsi Hospital, Shanghai 200126, China

出版时间: 2025-06-10 doi: 10.11876/mimt202503013

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摘要

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目的

研究CT灌注成像（CT perfusion，CTP）参数对急性脑梗死（acute cerebral infarction，ACI）患者侧支循环及静脉溶栓后功能结局的预测价值。

方法

以医院2021年1月至2024年11月收治的100例ACI患者为研究对象，均于入院后行CT灌注成像检查并进行静脉溶栓治疗。以数字血管造影（digital subtraction angiography，DSA）作为金标准将患者分为侧支良好组（46例）与侧支不良组（54例），对比两组患者CTP参数。根据发病90 d后改良Rankin量表（modified Rankin scale，mRS）评分，将患者分为功能结局良好组（65例）和功能结局不良组（35例）。采用受试者工作特征（receiver operating characteristic，ROC）曲线分析预测效能。

结果

相较于侧支不良组，侧支良好组脑血流量（cerebral blood flow，CBF）、脑血容量（cerebral blood volume，CBV）水平更高（P<0.05）、平均通过时间（mean transit time，MTT）、达峰时间（time to peak，TTP）水平更低（P<0.05）；ROC曲线结果显示，CBF、CBV、MTT、TTP及联合检测均对患者侧支循环有预测效能（P<0.05），其AUC分别为0.857、0.800、0.814、0.713、0.931，单独检测中CBF效能最高，但仍低于联合预测效能。采用独立样本Z检验得到CBF、CBV、MTT、TTP对联合预测的Z值分别为1.37（P>0.05）、2.21（P<0.05）、1.71（P>0.05）、3.54（P<0.05）。ROC曲线结果显示，CBF、CBV、MTT、TTP及联合检测均对患者静脉溶栓后功能结局有预测效能（P<0.05），其AUC分别为0.796、0.811、0.718、0.784、0.902，单独检测中CBV效能最高，但仍低于联合预测效能。采用独立样本Z检验得到CBF、CBV、MTT、TTP对联合预测的Z值分别为1.91（P>0.05）、1.65（P>0.05）、3.14（P<0.05）、2.13（P<0.05）。

结论

ACI患者侧支循环良好组CBF、CBV较侧支循环不良组高，MTT、TTP水平更低，功能结局良好组CTP参数与侧支循环良好组趋势相似。分析ROC得到CTP参数具有侧支循环及静脉溶栓后功能结局的预测效能。

关键词

CT灌注成像 / 急性脑梗死 / 静脉溶栓治疗 / 评估价值

Abstract

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Objective

To study the predictive value of CT perfusion imaging (CTP) parameters for collateral circulation and functional outcomes after intravenous thrombolysis in patients with acute cerebral infarction (ACI).

Methods

A total of 100 patients with ACI admitted to the hospital from January 2021 to November 2024 were selected as the research subjects. All of them underwent CT perfusion imaging examination and received intravenous thrombolytic therapy after admission. The patients were divided into the good collateral group (46 cases) and the poor collateral group (54 cases) using digital subtraction angiography (DSA) as the gold standard. Compare the CTP parameters of the two groups of patients. According to the modified Rankin scale (mRS) score 90 days after the onset of the disease, the patients were divided into the good functional outcome group (65 cases) and the poor functional outcome group (35 cases). The predictive efficacy was analyzed using the receiver operating characteristic (ROC) curve.

Results

Compared with the poor collateral group, the good collateral group had higher levels of cerebral blood flow (CBF) and cerebral blood volume (CBV) (P<0.05). The levels of mean transit time (MTT) and time to peak (TTP) were lower (P<0.05). The ROC curve results showed that CBF, CBV, MTT, TTP and the combined detection all had predictive efficacy for collateral circulation in patients (P<0.05), with AUC being 0.857, 0.800, 0.814, 0.713 and 0.931 respectively. Among the individual detections, CBF had the highest predictive efficacy but was still lower than the combined predictive efficacy. The Z values of CBF, CBV, MTT and TTP for the combined detection were calculated to be 1.37 (P>0.05), 2.21 (P<0.05), 1.71 (P>0.05) and 3.54 (P<0.05) respectively. The ROC curve results showed that CBF, CBV, MTT, TTP and the combined detection all had efficacy for the functional outcome of patients after intravenous thrombolysis (P<0.05), with AUC of 0.796, 0.811, 0.718, 0.784 and 0.902 respectively. Among the individual detects, CBV had the highest efficacy but was still lower than the combined predictive efficacy. The Z values of CBF, CBV, MTT and TTP for the combined detection were calculated to be 1.91 (P>0.05), 1.65 (P>0.05), 3.14 (P<0.05) and 2.13 (P<0.05) respectively.

Conclusion

In ACI patients, the levels of CBF and CBV in the good collateral circulation group were higher than those in the poor collateral circulation group, while the levels of MTT and TTP were lower. The CTP parameters in the good functional outcome group showed a similar trend to those in the good collateral circulation group. ROC analysis revealed that the CTP parameters had predictive efficacy for good collateral circulation and functional outcomes after intravenous thrombolysis.

Key words

CT perfusion imaging / Acute cerebral infarction / Intravenous thrombolytic therapy / Evaluation value

引用本文

刘娟. CT灌注成像参数对急性脑梗死患者侧支循环及静脉溶栓后功能结局的预测价值. 现代仪器与医疗, 2025 , 31 (3) : 73 -77 . DOI: 10.11876/mimt202503013

Juan Liu. The predictive value of CT perfusion imaging parameters for collateral circulation and functional outcomes after intravenous thrombolysis in patients with acute cerebral infarction[J]. Modern Instruments & Medical Treatment, 2025 , 31 (3) : 73 -77 . DOI: 10.11876/mimt202503013

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2025年第31卷第3期

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doi: 10.11876/mimt202503013

首发时间：2026-10-23
出版时间：2025-06-10

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上海杨思医院神经内科，上海　200126

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
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