[1]郭守文,李丽,李玲玲.头颈CTA联合CTP在急性缺血性脑卒中诊断及预后评估的价值[J].中国医学物理学杂志,2026,43(5):624-628.[doi:DOI:10.3969/j.issn.1005-202X.2026.05.009]
　GUO Shouwen,LI Li,LI Lingling.Diagnostic and prognostic value of head and neck CTA combined with CTP in acute ischemic stroke[J].Chinese Journal of Medical Physics,2026,43(5):624-628.[doi:DOI:10.3969/j.issn.1005-202X.2026.05.009]
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头颈CTA联合CTP在急性缺血性脑卒中诊断及预后评估的价值()

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

卷:
43卷
期数:
2026年第5期
页码:
624-628
栏目:
医学影像物理
出版日期:
2026-05-28

文章信息/Info

Title:
Diagnostic and prognostic value of head and neck CTA combined with CTP in acute ischemic stroke
文章编号:
1005-202X（2026）05-0624-05
作者:
郭守文1; 李丽2; 李玲玲1
1.六安市中医院放射科， 安徽 六安 237000； 2.六安市中医院CT室， 安徽 六安 237000
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
关键词:
急性缺血性脑卒中; 头颈计算机断层成像; 血管成像; 灌注成像
Keywords:
Keywords: acute ischemic stroke head and neck computed tomography angiography perfusion imaging
分类号:
R816.1
DOI:
DOI:10.3969/j.issn.1005-202X.2026.05.009
文献标志码:
A
摘要:
目的：探讨头颈计算机断层成像（CT）血管成像（CTA）联合CT灌注成像（CTP）在急性缺血性脑卒中（AIS）诊断及预后评估的价值。方法：选择2021年1月至2024年9月接诊的102例AIS患者为研究对象，入院后均行头颈CTA、CTP及数字减影血管造影（DSA）检查，以DSA结果为金标准，比较患侧、健侧CTP灌注参数差异，分析CTA对脑血管狭窄情况的诊断价值；所有患者确诊后均接受溶栓治疗，治疗后随访90 d，以改良Rankin量表判断预后情况，分析不同预后患者CTA和CTP参数差异，二元Logistic回归分析CTA和CTP参数与预后的关系，ROC分析CTA和CTP参数对预后的诊断价值。结果：患侧脑血流量（CBF）和脑血容量（CBV）值较健侧更低（P<0.05），平均通过时间（MTT）和对比剂达峰时间（TTP）更高（P<0.05）；以DSA为金标准，CTA诊断脑动脉狭窄的敏感度、特异度、准确率及Kappa值分别为89.29%、95.65%、92.16%及0.762；预后不良组发病至治疗时间、重度狭窄或闭塞患者占比、MTT和TTP高于预后良好组（P<0.05），轻中度狭窄患者占比、CBF和CBV低于预后良好组（P<0.05）；二元Logistics回归分析显示，CTA、CBF、CBV、MTT和TTP是AIS患者治疗预后的相关影响因素（P<0.05）；ROC分析结果显示，CTA、CBF、CBV、MTT和TTP诊断预后的AUC分别为0.706、0.947、0.934、0.870和0.915，联合评估AUC为0.988，敏感度和特异度分别为97.22%、78.79%。结论：头颈CTA联合CTP在AIS诊断和治疗后预后评估中有一定应用价值。
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.

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备注/Memo

备注/Memo:
【收稿日期】2025-11-23 【基金项目】安徽省重点研究与开发计划（2022e07020007） 【作者简介】郭守文，主治医师，研究方向：心脑血管病，E-mail: guoshouwen88@163.com 【通信作者】李丽，副主任医师，研究方向：心脑血管病，E-mail: 497058981@qq.com
更新日期/Last Update: 2026-05-29