Department of Neurology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200062, P.R. China.
Department of Radiology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200062, P.R. China.
BMC Neurol. 2024 Feb 9;24(1):59. doi: 10.1186/s12883-024-03554-x.
Computed tomographic perfusion (CTP) can play an auxiliary role in the selection of patients with acute ischemic stroke for endovascular treatment. However, data on CTP in non-stroke patients with intracranial arterial stenosis are scarce. We aimed to investigate images in patients with asymptomatic intracranial arterial stenosis to determine the detection accuracy and interpretation time of large/medium-artery stenosis or occlusion when combining computed tomographic angiography (CTA) and CTP images.
We retrospectively reviewed 39 patients with asymptomatic intracranial arterial stenosis from our hospital database from January 2021 to August 2023 who underwent head CTP, head CTA, and digital subtraction angiography (DSA). Head CTA images were generated from the CTP data, and the diagnostic performance for each artery was assessed. Two readers independently interpreted the CTA images before and after CTP, and the results were analyzed.
After adding CTP maps, the accuracy (area under the curve) of diagnosing internal carotid artery (R1: 0.847 vs. 0.907, R2: 0.776 vs. 0.887), middle cerebral artery (R1: 0.934 vs. 0.933, R2: 0.927 vs. 0.981), anterior cerebral artery (R1: 0.625 vs. 0.750, R2: 0.609 vs. 0.750), vertebral artery (R1: 0.743 vs. 0.764, R2: 0.748 vs. 0.846), and posterior cerebral artery (R1: 0.390 vs. 0.575, R2: 0.390 vs. 0.585) occlusions increased for both readers (p < 0.05). Mean interpretation time (R1: 72.4 ± 6.1 s vs. 67.7 ± 6.4 s, R2: 77.7 ± 3.8 s vs. 72.6 ± 4.7 s) decreased when using a combination of both images both readers (p < 0.001).
The addition of CTP images improved the accuracy of interpreting CTA images and reduced the interpretation time in asymptomatic intracranial arterial stenosis. These findings support the use of CTP imaging in patients with asymptomatic intracranial arterial stenosis.
计算机断层灌注（CTP）可在急性缺血性脑卒中患者的血管内治疗选择中发挥辅助作用。然而，关于伴有颅内动脉狭窄的非卒中性患者的 CTP 数据很少。我们旨在研究无症状性颅内动脉狭窄患者的影像，以确定当结合计算机断层血管造影（CTA）和 CTP 图像时，对大/中动脉狭窄或闭塞的检测准确性和解释时间。
我们回顾性分析了 2021 年 1 月至 2023 年 8 月我院数据库中 39 例无症状性颅内动脉狭窄患者的头部 CTP、头部 CTA 和数字减影血管造影（DSA）资料。CTP 数据生成 CTA 图像，评估每条动脉的诊断性能。两名读者分别在 CTP 前后独立解释 CTA 图像，并对结果进行分析。
添加 CTP 图后，颈内动脉（R1：0.847 比 0.907，R2：0.776 比 0.887）、大脑中动脉（R1：0.934 比 0.933，R2：0.927 比 0.981）、大脑前动脉（R1：0.625 比 0.750，R2：0.609 比 0.750）、椎动脉（R1：0.743 比 0.764，R2：0.748 比 0.846）和大脑后动脉（R1：0.390 比 0.575，R2：0.390 比 0.585）闭塞的诊断准确性（曲线下面积）均增加（p < 0.05）。当两位读者同时使用两种图像时，平均解释时间（R1：72.4 ± 6.1 s 比 67.7 ± 6.4 s，R2：77.7 ± 3.8 s 比 72.6 ± 4.7 s）均减少（p < 0.001）。
CTP 图像的添加提高了 CTA 图像的解释准确性，并减少了无症状性颅内动脉狭窄的解释时间。这些发现支持在无症状性颅内动脉狭窄患者中使用 CTP 成像。
