多模态CT影像学参数在脑梗死TOAST分型鉴别中的应用价值-《中国医学物理学杂志》

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Title:: Application potential of multimodal CT imaging parameters in differentiation of TOAST classification for cerebral infarction

文章编号:: 1005-202X（2025）10-1348-05

作者:: 铁培培1; 郑琪1; 何可2; 王国亮3; 1.淮南市新华医疗集团新华医院医学影像科，安徽淮南 232000； 2.淮南市新华医疗集团新华医院神经内科，安徽淮南 232000； 3.合肥市第三人民医院影像科，安徽合肥 230000

Author(s):: TIE Peipei1; ZHENG Qi1; HE Ke2; WANG Guoliang3; 1. Department of Medical Imaging, Xinhua Hospital, Huainan Medical Group, Huainan 232000, China 2.Department of Neurology, Xinhua Hospital, Huainan Medical Group, Huainan 232000, China 3.Department of Imaging, the Third Peoples Hospital of Hefei, Hefei 230000, China

关键词:: 多模态CT; 影像学参数; 脑梗死; TOAST分型

Keywords:: Keywords: multimodal CT imaging parameter cerebral infarction TOAST classification

分类号:: R816.1

DOI:: DOI:10.3969/j.issn.1005-202X.2025.10.012

文献标志码:: A

摘要:: 目的：分析多模态CT影像学参数在脑梗死TOAST分型鉴别中的应用价值。方法：选取103例脑梗死患者，根据TOAST分型分为5组：大动脉粥样硬化型（LAA组）、心源性栓塞型（CE组）、小动脉闭塞型（SAO组）、其他类型（SOD组）、不明原因型（SUE组）。所有患者均经CT平扫及CT血管成像（CTA）检查，以脑血管造影为金标准。结果：多模态CT影像学诊断LAA组、CE组、SAO组、SOD组和SUE组真阳性率分别为73.17%、45.45%、75.00%、40.00%、72.00%，灵敏度分别为90.10%、85.71%、92.30%、85.71%、90.00%，特异度分别为75.00%、75.00%、66.67%、66.67%、80.00%，漏诊率分别为9.09%、28.57%、7.69%、14.28%、10.00%，误诊率分别为25.00%、25.00%、33.33%、33.33%、20.00%，阳性预测率分别为93.75%、83.33%、92.31%、85.71%、94.74%，阴性预测率分别为66.67%、60.00%、66.67%、66.67%、66.67%；Kappa检验结果显示，多模态CT影像学检查结果与金标准具有高度一致性（Kappa>0.75, P<0.05）。结论：多模态CT影像学技术能够有效辅助脑梗死TOAST的分型鉴别，提高临床诊断的准确性。

Abstract:: Abstract: Objective To analyze the application value of multimodal CT imaging parameters in the differentiation of TOAST classification for cerebral infarction. Methods According to the TOAST classification,the selected 103 patients with cerebral infarction were categorized into large-artery atherosclerosis (LAA) group, cardioembolic (CE) group, small-artery occlusion (SAO) group, other determined etiologies (SOD) group, and undetermined etiologies (SUE) group. All patients underwent non-contrast CT scanning and CT angiography. Cerebral angiography was adopted as the gold standard. Results For the LAA, CE, SAO, SOD, and SUE groups, the diagnostic performance of multimodal CT imaging was as followed: true positive rates were 73.17%, 45.45%, 75.00%, 40.00%, and 72.00% sensitivities were 90.10%, 85.71%, 92.30%, 85.71%, and 90.00% specificities were 75.00%, 75.00%, 66.67%, 66.67%, and 80.00% miss rates were 9.09%, 28.57%, 7.69%, 14.28%, and 10.00% misdiagnosis rates were 25.00%, 25.00%, 33.33%, 33.33%, and 20.00% positive predictive rates were 93.75%, 83.33%, 92.31%, 85.71%, and 94.74% and negative predictive rates were 66.67%, 60.00%, 66.67%, 66.67%, and 66.67%, respectively. Kappa test results showed that the multimodal CT imaging findings were highly consistent with the gold standard (Kappa>0.75, P<0.05). Conclusion Multimodal CT imaging technology can effectively assist in the differentiation of TOAST classification for cerebral infarction, thereby improving the accuracy of clinical diagnosis.

《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

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