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急性缺血性脑卒中患者的灌注计算机断层扫描与临床状况

Perfusion computed tomography and clinical status of patients with acute ischaemic stroke.

作者信息

Popiela Tadeusz, Pera Joanna, Chrzan Robert, Strojny Jacek, Urbanik Andrzej, Słowik Agnieszka

机构信息

Katedra Radiologii, Department of Neurology, Jagiellonian University, ul. Botaniczna 3, 31-503 Krakow, Poland.

出版信息

Neurol Neurochir Pol. 2008 Sep-Oct;42(5):396-401.

Abstract

BACKGROUND AND PURPOSE

There is increasing availability of perfusion computed tomography (PCT) for assessment of acute ischaemic stroke patients. A semiquantitative evaluation of CT scans can be easily and quickly performed by the examining physician. In the current study, we investigated the correlation between the Alberta Stroke Program Early CT Score (ASPECTS) quantifying acute ischaemic changes on CT scans and clinical status of ischaemic stroke patients.

MATERIAL AND METHODS

We analyzed the data of 34 patients with hemispheric ischaemic stroke, in whom both non-contrast CT (NCCT) and PCT were performed within 12 hours after stroke onset. NCCT and PCT [colour-coded maps of cerebral blood flow (CBF), cerebral blood volume (CBV), and time-to-peak (TTP)] were evaluated using ASPECTS. The correlations between ASPECTS and severity of neurological deficit, and prognostic value of ASPECTS for long-term clinical outcome were studied.

RESULTS

We found a significant correlation between the baseline clinical status and ASPECTS for all CT techniques as well as between CBV and neurological deficit at discharge. ASPECTS ł7 in all CT techniques had a high sensitivity and positive predictive value for prognosis of 3-month functional independency.

CONCLUSIONS

ASPECTS used for PCT and NCCT shows a good correlation with clinical status and prognosis of ischaemic stroke patients.

摘要

背景与目的

灌注计算机断层扫描(PCT)在急性缺血性脑卒中患者评估中的应用越来越广泛。检查医师可以轻松、快速地对CT扫描进行半定量评估。在本研究中,我们调查了用于量化CT扫描急性缺血性改变的阿尔伯塔卒中项目早期CT评分(ASPECTS)与缺血性脑卒中患者临床状况之间的相关性。

材料与方法

我们分析了34例半球缺血性脑卒中患者的数据,这些患者在卒中发作后12小时内均进行了非增强CT(NCCT)和PCT检查。使用ASPECTS对NCCT和PCT[脑血流量(CBF)、脑血容量(CBV)和达峰时间(TTP)的彩色编码图]进行评估。研究了ASPECTS与神经功能缺损严重程度之间的相关性,以及ASPECTS对长期临床结局的预后价值。

结果

我们发现,所有CT技术的基线临床状况与ASPECTS之间以及出院时CBV与神经功能缺损之间均存在显著相关性。所有CT技术中ASPECTS≥7对3个月功能独立性预后具有高敏感性和阳性预测值。

结论

用于PCT和NCCT的ASPECTS与缺血性脑卒中患者的临床状况和预后具有良好的相关性。

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