中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2012年
7期
593-597
,共5页
熊兵%陈伟建%付凤丽%段玉霞%杨博洋%王宏清%杨运俊%梁盼%林怡%王殊%吴楠%童秋云
熊兵%陳偉建%付鳳麗%段玉霞%楊博洋%王宏清%楊運俊%樑盼%林怡%王殊%吳楠%童鞦雲
웅병%진위건%부봉려%단옥하%양박양%왕굉청%양운준%량반%림이%왕수%오남%동추운
脑血管意外%毛细血管通透性%体层摄影术,X线计算机
腦血管意外%毛細血管通透性%體層攝影術,X線計算機
뇌혈관의외%모세혈관통투성%체층섭영술,X선계산궤
Cerebrovascular accident%Capillary permeability%Tomography,X-ray computed
目的 探讨CT灌注表面通透性(PS)在预测急性缺血性脑卒中(AIS)后出血性转化(HT)中的价值.方法 发病3～9h内的AIS患者31例,全部行头颅CT平扫和灌注(CTP)检查,根据复查CT平扫图像判断患者有无发生HT,将入选患者分为出血组(11例)及未出血组(20例),测量患者患侧和健侧PS、脑血流量(CBF)、脑血容量(CBV)及平均通过时间(MTT)值,并计算其比值,得到相对表面通透性(rPS)、相对脑血流量(rCBF)、相对脑血容量(rCBV)及相对平均通过时间(rMTT)值.采用Wilcoxon秩和检验比较分析出血组及未出血组rPS之间的差异,采用独立样本t检验比较两组rCBF、rCBV、rMTF及两组患侧PS值的差异,采用Spearman秩相关分析各灌注参数与HT间的相关性.结果 出血组和未出血组患侧PS值分别为(1.61±0.77)、(0.91±0.49)ml·min-1·100 g-1;出血组rPS、rCBF、rCBV、rMTT值分别为2.76±0.78、0.32±0.18、0.66±0.31、2.67±0.71,未出血组对应数值分别为1.35±0.19、0.50±0.21、0.91 ±0.28、2.62±1.31,与未出血组患者相比,出血组患者的rPS值及PS值较高,差异有统计学意义(U=0.000,t=3.070;P值均＜0.01);出血组rCBF、rCBV值较未出血组减低,差异有统计学意义(t值分别为2.343、2.210;P值均＜0.05);两组rMTT值差异无统计学意义(t =0.118,P＞0.05).PS及rPS值均与HT呈正相关(相关系数r值分别为0.496、0.821,P值均＜0.01),其中rPS与HT相关性较高.结论 CT灌注rPS值在预测AIS后HT中有重要意义,有利于指导临床个性化治疗方案的制定,降低患者不良反应的发生.
目的 探討CT灌註錶麵通透性(PS)在預測急性缺血性腦卒中(AIS)後齣血性轉化(HT)中的價值.方法 髮病3～9h內的AIS患者31例,全部行頭顱CT平掃和灌註(CTP)檢查,根據複查CT平掃圖像判斷患者有無髮生HT,將入選患者分為齣血組(11例)及未齣血組(20例),測量患者患側和健側PS、腦血流量(CBF)、腦血容量(CBV)及平均通過時間(MTT)值,併計算其比值,得到相對錶麵通透性(rPS)、相對腦血流量(rCBF)、相對腦血容量(rCBV)及相對平均通過時間(rMTT)值.採用Wilcoxon秩和檢驗比較分析齣血組及未齣血組rPS之間的差異,採用獨立樣本t檢驗比較兩組rCBF、rCBV、rMTF及兩組患側PS值的差異,採用Spearman秩相關分析各灌註參數與HT間的相關性.結果 齣血組和未齣血組患側PS值分彆為(1.61±0.77)、(0.91±0.49)ml·min-1·100 g-1;齣血組rPS、rCBF、rCBV、rMTT值分彆為2.76±0.78、0.32±0.18、0.66±0.31、2.67±0.71,未齣血組對應數值分彆為1.35±0.19、0.50±0.21、0.91 ±0.28、2.62±1.31,與未齣血組患者相比,齣血組患者的rPS值及PS值較高,差異有統計學意義(U=0.000,t=3.070;P值均＜0.01);齣血組rCBF、rCBV值較未齣血組減低,差異有統計學意義(t值分彆為2.343、2.210;P值均＜0.05);兩組rMTT值差異無統計學意義(t =0.118,P＞0.05).PS及rPS值均與HT呈正相關(相關繫數r值分彆為0.496、0.821,P值均＜0.01),其中rPS與HT相關性較高.結論 CT灌註rPS值在預測AIS後HT中有重要意義,有利于指導臨床箇性化治療方案的製定,降低患者不良反應的髮生.
목적 탐토CT관주표면통투성(PS)재예측급성결혈성뇌졸중(AIS)후출혈성전화(HT)중적개치.방법 발병3～9h내적AIS환자31례,전부행두로CT평소화관주(CTP)검사,근거복사CT평소도상판단환자유무발생HT,장입선환자분위출혈조(11례)급미출혈조(20례),측량환자환측화건측PS、뇌혈류량(CBF)、뇌혈용량(CBV)급평균통과시간(MTT)치,병계산기비치,득도상대표면통투성(rPS)、상대뇌혈류량(rCBF)、상대뇌혈용량(rCBV)급상대평균통과시간(rMTT)치.채용Wilcoxon질화검험비교분석출혈조급미출혈조rPS지간적차이,채용독립양본t검험비교량조rCBF、rCBV、rMTF급량조환측PS치적차이,채용Spearman질상관분석각관주삼수여HT간적상관성.결과 출혈조화미출혈조환측PS치분별위(1.61±0.77)、(0.91±0.49)ml·min-1·100 g-1;출혈조rPS、rCBF、rCBV、rMTT치분별위2.76±0.78、0.32±0.18、0.66±0.31、2.67±0.71,미출혈조대응수치분별위1.35±0.19、0.50±0.21、0.91 ±0.28、2.62±1.31,여미출혈조환자상비,출혈조환자적rPS치급PS치교고,차이유통계학의의(U=0.000,t=3.070;P치균＜0.01);출혈조rCBF、rCBV치교미출혈조감저,차이유통계학의의(t치분별위2.343、2.210;P치균＜0.05);량조rMTT치차이무통계학의의(t =0.118,P＞0.05).PS급rPS치균여HT정정상관(상관계수r치분별위0.496、0.821,P치균＜0.01),기중rPS여HT상관성교고.결론 CT관주rPS치재예측AIS후HT중유중요의의,유리우지도림상개성화치료방안적제정,강저환자불량반응적발생.
Objective To investigate the value of permeability surface (PS) in predicting hemorrhagic transformation (HT) in acute ischernic stroke (AIS) using CT peffusion (CTP).Methods The study included 31 consecutive patients who presented symptoms suggestive of an AIS for 3-9 h. All patients underwent CT examination (noncontrast CT,CTP).HT was determined by follow-up CT images.According to presence of HT,the AIS was divided into HT group (PSHT,11 patients) and non-HT group (PSNo-HT,20 patients).PS,cerebral blood flow (CBF),cerebral blood volume (CBV) and mean transit time (MTT) on both sides of brains were measured.The relative PS(rPS),relative CBF (rCBF),relative CBV(rCBV) and relative MTT(rMTT) were obtained by calculating the ratio of the values of bilateral regions.The rPS between PSHT and PSNo-HT was compared with an exact Wilcoxon signed-rank test. The rCBF,rCBV,rMTT and the PS of the ischemic side between PSHr and PSNo-HT were compared with independent-sample t test.Meanwhile,Spearman rank correlation analysis was conducted to analyze the relationship between the CTP parameters and HT.Results The PS value of ischemic side was (1.61 ±0.77) ml · min - 1 · 100 g-1 for the PSHT group,and the value was (0.91 ± 0.49) ml · min - 1 · 100 g- 1 for the PSNo-HT group.For the PSHT group,rPS,rCBF,rCBV,rMTT were 2.76 ±0.78,0.32 ±0.18,0.66 ±0.31,2.67 ±0.71,and for the PSNo-HT group,rPS,rCBF,rCBV,rMTT were 1.35 ±0.19,0.50±0.21,0.91 ±0.28,2.62 ± 1.31.Compared with PSNo-HT,PSHT had higher rPS and PS value,and there were significant statistical differences (U =0.000,t =3.070,P ＜0.01).But rCBF and rCBV values were lower in the PSHT group compared to the PSNo-HT group,and there were significant statistical differences (trCsF =2.343,trCBV =2.210,P ＜ 0.05).There was no significant statistical difference in rMTT between the two groups(t =0.118,P ＞ 0.05).Significant positive correlations were detected between the rPS and PS with HT(r=0.496,0.821,P ＜0.01).Conclusions The value of rPS is helpful in predicting HT in AIS.And it can be used as a predictor in determining clinical personalized treatment and thus reduce the incidence of adverse events.
