Predictive value of spectral CTA parameters for infarct core in acute ischemic stroke
10.3760/cma.j.issn.1671-0282.2024.11.017
- VernacularTitle:光谱CTA参数对急性缺血性脑卒中梗死核心的预测价值
- Author:
Yan GU
1
;
Dai SHI
;
Yeqing WANG
;
Dandan XU
;
Aoqi XIAO
;
Dan JIN
;
Kuan LU
;
Wu CAI
;
Guohua FAN
;
Junkang SHEN
;
Liang XU
Author Information
1. 苏州大学附属第二医院影像科，苏州 215004
- Keywords:
Dual-detector spectral CT;
Acute ischemic stroke;
Infarct core;
Iodine density values;
Predictive value
- From:
Chinese Journal of Emergency Medicine
2024;33(11):1572-1579
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the value of dual-detector spectral CTA in distinguishing infarct core from penumbra in patients with acute ischemic stroke(AIS), and to further explore the risk factors associated with infarct core and their predictive value.Methods:The imaging and clinical data of 163 patients with AIS who met the inclusion criteria admitted to the Second Affiliated Hospital of Soochow University from March 2022 to May 2023 were retrospectively analyzed. Patients from March 2022 to December 2022 were used as the training group, and patients from January 2023 to May 2023 were used as the validation group for internal validation. The head and neck spectral CTA and brain CT perfusion imaging with dual-layer detector spectral CT were all carried out on all patients. Using CTP as reference, the patients were divided into infarct core group and non-infarct core group according to whether an infarct core occurred in the hypoperfusion regions of brain tissue. Multivariate logistic regression analysis was used to screen predictors related to the infarct core. The receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy.Results:A total of 163 patients were included in the study, including 112 in the training group and 51 in the validation group. There were significant differences in iodine density, effective atomic number, hypertension, triglyceride and neutrophils between the two groups ( P< 0.05). The cutoff values for iodine density values and effective atomic number values were 0.215 mg/mL and 7.405, respectively. Multivariate logistic regression analysis showed that iodine density and hypertension were independent risk factors for infarct core in AIS, and triglyceride was an independent protective factor. The area under the ROC curve (AUC) of iodine density value was the largest (0.859), with a sensitivity of 70.27%, and a specificity of 90.67%, which had a good predictive value. The ROC curve analysis results for the validation group were consistent with the training group. Conclusions:Spectral CT parameters iodine density values and effective atomic number values have the potential to distinguish the infarct core area from the penumbra area in patients with AIS. Iodine density and hypertension were independent risk factors of infarct core in AIS, triglyceride was an independent protective factor, and iodine density values obtained by dual-layer spectral detector CT had a high predictive value.
