Diagnostic and prognostic value of head and neck CTA combined with CTP in acute ischemic stroke(PDF)
《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]
- Issue:
- 2026年第5期
- Page:
- 624-628
- Research Field:
- 医学影像物理
- Publishing date:
Info
- Title:
- Diagnostic and prognostic value of head and neck CTA combined with CTP in acute ischemic stroke
- Author(s):
- GUO Shouwen1; LI Li2; LI Lingling1
- 1. Department of Radiology, Luan Hospital of Traditional Chinese Medicine, Luan 237000, China 2. CT Room, Luan Hospital of Traditional Chinese Medicine, Luan 237000, China
- Keywords:
- Keywords: acute ischemic stroke head and neck computed tomography angiography perfusion imaging
- PACS:
- R816.1
- DOI:
- DOI:10.3969/j.issn.1005-202X.2026.05.009
- Abstract:
- Abstract: Objective To investigate the value of head and neck computed tomography angiography (CTA) combined with CT perfusion (CTP) in the diagnosis and prognostic evaluation of acute ischemic stroke (AIS). Methods A total of 102 AIS patients admitted from January 2021 to September 2024 were enrolled. Head and neck CTA, CTP, and digital subtraction angiography (DSA) were performed after admission. Taking DSA findings as the gold standard, the differences in CTP parameters between the affected and contralateral healthy sides were compared, and the diagnostic value of CTA for cerebrovascular stenosis was analyzed. All patients received thrombolytic therapy after confirmed diagnosis, and were followed up for 90 days after treatment. The modified Rankin scale was used for prognostic assessment. Differences in CTA and CTP parameters were compared between patients with different prognostic outcomes. Binary Logistic regression analysis was performed to explore the correlations of CTA and CTP parameters with prognosis, and receiver operating characteristic (ROC) curve was used to evaluate the prognostic diagnostic efficacy of these parameters. Results Cerebral blood flow (CBF) and cerebral blood volume (CBV) were significantly lower, and the mean transit time (MTT) and time to peak (TTP) were prolonged on the affected side relative to the contralateral healthy side (all P<0.05). Using DSA as the gold standard, CTA demonstrated a sensitivity, specificity, accuracy, and Kappa value of 89.29%, 95.65%, 92.16%, and 0.762 in diagnosing cerebral artery stenosis. Compared with the good prognosis group, the poor prognosis group showed a longer time from onset to treatment, a higher proportion of patients with severe stenosis or occlusion, prolonged MTT and TTP, a lower proportion of patients with mild-to-moderate stenosis, and decreased CBF and CBV (all P<0.05). Binary Logistics regression analysis identified CTA, CBF, CBV, MTT, and TTP as influencing factors for prognostic outcomes in AIS patients (P<0.05). ROC analysis revealed that the AUC values of CTA, CBF, CBV, MTT and TTP for predicting prognostic outcomes were 0.706, 0.947, 0.934, 0.870, and 0.915, respectively. The AUC, sensitivity and specificity of the combined model were 0.988, 97.22% and 78.79%, respectively. Conclusion Head and neck CTA combined with CTP has certain application value in the diagnosis of AIS and the evaluation of post-treatment prognosis.
Last Update: 2026-05-29