CT灌注成像评价脑缺血在健康管理中的应用价值

Application Value of CT Perfusion Imaging in Evaluating Cerebral Ischemia in Health Management

摘要: 目的：探讨CT灌注成像评价脑缺血在健康管理中的应用价值。方法：选取2022年1月至2024年2月期间在我院检查的具有脑血管合并症或高危因素老年人群120例(观察组)，另选取同时期在我院进行常规体检的健康志愿者60例(对照组)。均在院经头颅CT检查，观察CT灌注成像参数变化，随访6个月，将患者随访结果或检查后经数字减影血管造影检查结果作为比较，分析CT灌注成像诊断脑缺血的临床价值，并对比脑缺血组与非脑缺血组CT灌注成像参数差异。结果：120例具有脑血管合并症或高危因素老年人群确诊为脑缺血患者38例(31.67%)。综合CT灌注成像所有参数诊断脑缺血的灵敏度及准确性均高于头颅CT平扫，差异有统计学意义(P < 0.05)。脑缺血组脑血流量(CBF)、脑血容量(CBV)值低于非脑缺血组与对照组，平均通过时间(MTT)及达峰时间(TTP)值高于非脑缺血组与对照组，差异有统计学意义(P < 0.05)。缺血半暗带区域CBF、CBV值高于梗死区，TTP、MTT值低于梗死组，差异有统计学意义(P < 0.05)；缺血半暗带区域相对值rCBF、rCBV高于梗死区，rTTP、rMTT值低于梗死组，差异有统计学意义(P < 0.05)。结论：CT灌注成像评价脑缺血在健康管理中的应用价值较高，早期诊断率高，可作为具有脑缺血高危因素或脑缺血合并症患者头颅CT检查中的重要技术。

Abstract: Objective: To explore the application value of CT perfusion imaging in evaluating cerebral ischemia in health management. Methods: A total of 120 elderly patients with cerebrovascular complications or high-risk factors who were examined in our hospital from January 2022 to February 2024 were selected as the observation group. Another 60 healthy volunteers who underwent routine physical examinations in our hospital during the same period were selected as the control group. All patients underwent head CT examination in the hospital, and changes in CT perfusion imaging parameters were observed. Follow-up for 6 months was conducted, and the patient follow-up results or the results of digital subtraction angiography after examination were compared to analyze the clinical value of CT perfusion imaging in diagnosing cerebral ischemia, and the differences in CT perfusion imaging parameters between the cerebral ischemia group and the non cerebral ischemia group were compared. Results: Among the 120 elderly patients with cerebrovascular complications or high-risk factors, 38 (31.67%) were diagnosed with cerebral ischemia. The sensitivity and accuracy of all parameters of comprehensive CT perfusion imaging in diagnosing cerebral ischemia were higher than those of head CT scan, and the difference was statistically significant (P < 0.05). The cerebral blood flow (CBF) and cerebral blood volume (CBV) values in the cerebral ischemia group were lower than those in the non-cerebral ischemia group and the control group. The average transit time (MTT) and peak time (TTP) values were higher than those in the non-cerebral ischemia group and the control group, and the differences were statistically significant (P < 0.05). The CBF and CBV values in the ischemic penumbra area were higher than those in the infarcted area, while the TTP and MTT values were lower than those in the infarcted group, the difference being statistically significant (P < 0.05). The relative values of rCBF and rCBV in the ischemic penumbra area were higher than those in the infarcted area, rTTP and rMTT values were lower than those in the infarction group, and the difference was statistically significant (P < 0.05). Conclusion: Evaluation of cerebral ischemia by CT perfusion imaging has high application value in health management and high early diagnosis rate. It can be used as an important technique in head CT examination in patients with high-risk factors of cerebral ischemia or complications of cerebral ischemia.