Value of CT Perfusion in Predicting the Prognosis of Patients with Acute Cerebral Infarction
- VernacularTitle:一站式CTP对预测急性脑梗死患者预后的评估价值
- Author:
Dan WEI
1
;
Jing ZHAO
2
;
Chao DANG
3
;
Yan-zhao XIE
4
;
Ding-xiang XIE
2
;
Xu-feng YANG
2
;
Hong-bing CHEN
3
;
Li JIANG
2
Author Information
1. Department of Radiology， Huizhou ZhongdaHuiya Hospital， Huizhou 516081， China
2. Department of Radiology， The First Affiliated Hospital， Sun Yat-sen University， Guangzhou 510080， China
3. Department of Neurology， The First Affiliated Hospital， Sun Yat-sen University， Guangzhou 510080， China
4. Department of Radiology， Zhuhai Hospital， Guangdong Hospital of Traditional Chinese Medicine， Zhuhai 519015， China
- Publication Type:Journal Article
- Keywords:
NIHSS;
ASPECTS;
CT perfusion;
acute ischemia stroke;
prognosis
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2021;42(2):279-286
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo analyze the clinical data of CT perfusion imaging （CTP） before and after treatment in acute ischemia stroke （AIS） patients， and to identify the imaging and clinical features related to prognosis. MethodsA total of 39 CT/MRI confirmed AIS patients （Male： Female = 21：18， mean age： 65 years， mean onset time： 8.4 h） were prospectively included， and they were followed for 90 days to obtain their mRS score （mean 2.8）. All patients underwent 320-row spiral CTP scan， and non-contrast CT （NCCT）， CT angiography （CTA） and CT perfusion （CTP） were generated. ASPECTS score and CTP perfusion parameters （CBF， CBV， MTT， TTP， Delay-TTP） were calculated. In addition， the volume of cerebral ischemia core， ischemic penumbra and their ratio were obtained. Three ROIs with similar size were placed in the cerebral infarction core， ischemic penumbra and corresponding contralateral brain parenchyma， and all the parameters were measured three times respectively， to take the average value. ResultsOf 39 AIS patients， 20 patients showed good prognosis （mRS≤2）. Correlation analysis showed that NIHSS score， ischemia core volume， MTT and delayed-TTP in ischemic penumbra were significantly positively correlated with mRS scores at 90 days （P≤0.04）， while the post-treatment ASPECTS and CBF in the ischemia core were significantly negatively correlated with mRS scores at 90 days （P< 0.05）. Further comparative analysis demonstrated that NIHSS score before and after treatment， ASPECTS after treatment and ischemia core volume and CBF in ischemia core were significantly different in AIS patients with good or bad prognosis （P≤0.03）. ROC analysis showed that NIHSS score had the highest diagnostic value in predicting the prognosis of AIS patients （AUC： 0.90）， and the sensitivity， specificity and cut-off values were 79%， 85% and 4.5， respectively. CBF in the ischemia core had the best specificity （89%） and the post-treatment ASPECTS demonstrated the highest sensitivity （94%） in prognosis predicting of AIS patients. ConclusionsIschemia core volume， CBF， NIHSS score before and after treatment， and post-treatment ASPECTS of AIS patients are closely related with their prognosis. Compared with NIHSS score， the ischemia core CBF has a higher specificity in predicting the prognosis of AIS patients.
