使用灌注计算机断层扫描定义不可逆性脑缺血的范围。
Defining the extent of irreversible brain ischemia using perfusion computed tomography.
机构信息
Department of Neurology and Hunter Medical Research Institute, University of Newcastle, Newcastle, N.S.W., Australia.
出版信息
Cerebrovasc Dis. 2011;31(3):238-45. doi: 10.1159/000321897. Epub 2010 Dec 21.
BACKGROUND
Perfusion computed tomography (PCT) shows promise in acute stroke assessment. However, the accuracy of CT perfusion thresholds in defining the acute infarct core remains uncertain.
METHOD
Concurrent PCT and MRI-DWI performed 3-6 h after symptoms onset were assessed in 57 ischemic stroke patients. PCT was compared to DWI images to define the infarct core using a pixel-based receiver operating characteristic curve analysis to calculate the area under the curve (AUC) for thresholds from PCT maps that were co-registered with the DWI slice location.
RESULTS
A relative cerebral blood flow (CBF) of 45% of the contralateral hemisphere was found to be the most accurate threshold for describing the infarct core (AUC 0.788), and it was also by far the most frequent threshold with the highest AUC across patients.
CONCLUSION
CBF thresholds on PCT define the acute infarct core more accurately than do other PCT thresholds, including a cerebral blood volume of 2 ml/100 g.
背景
灌注计算机断层扫描（PCT）在急性脑卒中评估中具有应用前景。然而，CT 灌注阈值在定义急性梗死核心方面的准确性仍不确定。
方法
对 57 例缺血性脑卒中患者发病后 3-6 小时进行同步 PCT 和 MRI-DWI 检查。使用基于像素的受试者工作特征曲线分析，将 PCT 与 DWI 图像进行比较，以定义梗死核心，计算与 DWI 层面位置配准的 PCT 图上的曲线下面积（AUC），从而确定阈值。
结果
发现相对脑血流量（CBF）为对侧半球的 45%是描述梗死核心最准确的阈值（AUC 为 0.788），也是迄今为止患者中最常见且 AUC 值最高的阈值。
结论
PCT 上的 CBF 阈值比其他 PCT 阈值更能准确地定义急性梗死核心，包括脑血容量为 2ml/100g。
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