Pan Jiawei, Zhang Jun, Huang Weiyuan, Cheng Xin, Ling Yifeng, Dong Qiang, Geng Daoying
From the Departments of *Radiology, and †Neurology, Huashan Hospital, Fudan University, Shanghai, China.
J Comput Assist Tomogr. 2013 Sep-Oct;37(5):645-9. doi: 10.1097/RCT.0b013e31829866fc.
This study aimed to perform an evaluation of 4 perfusion computed tomographic (PCT) parameters (relative cerebral blood flow, cerebral blood volume, mean transit time [MTT], and delay time [DT]) in a series of patients with acute ischemic stroke to find optimal parameters to predict infarct core and penumbra.
Twenty-six patients with symptoms suggesting stroke less than 7 hours from onset were enrolled in this study. They all underwent admission and 24-hour PCT and a 24-hour diffusion-weighted imaging. Perfusion computed tomographic maps were assessed for relative reduced cerebral blood flow and cerebral blood volume and increased MTT and DT. Receiver operating characteristic curve analysis was performed to locate the optimal threshold for each parameter, using diffusion-weighted imaging as the gold standard.
The PCT parameter that most accurately describes the penumbra is the relative MTT of 150% or greater (area under the curve, 0.827; 95% confidence interval, 0.826-0.827), whereas the parameter that most accurately describes the infarct core is the relative DT of + 2.0 seconds or greater (area under the curve, 0.879; 95% confidence interval, 0.878-0.879).
The optimal parameters to define the infarct core and the penumbra are relative DT (≥+ 2.0 seconds) and relative MTT (≥ 150%).
本研究旨在对一系列急性缺血性卒中患者的4种灌注计算机断层扫描（PCT）参数（相对脑血流量、脑血容量、平均通过时间[MTT]和延迟时间[DT]）进行评估，以找到预测梗死核心和半暗带的最佳参数。
本研究纳入了26例发病时间小于7小时且有卒中症状的患者。他们均接受了入院时和24小时的PCT检查以及24小时的弥散加权成像检查。评估灌注计算机断层扫描图像，观察相对脑血流量和脑血容量降低以及MTT和DT增加的情况。以弥散加权成像作为金标准，进行受试者操作特征曲线分析，以确定每个参数的最佳阈值。
最准确描述半暗带的PCT参数是相对MTT为150%或更高（曲线下面积，0.827；95%置信区间，0.826 - 0.827），而最准确描述梗死核心的参数是相对DT为+2.0秒或更高（曲线下面积，0.879；95%置信区间，0.878 - 0.879）。
定义梗死核心和半暗带的最佳参数是相对DT（≥ +2.0秒）和相对MTT（≥ 150%）。
