4DCTP在颈内动脉闭塞中的应用

Application of 4DCTP in Internal Carotid Artery Occlusion

摘要: 本研究探讨了4DCTP在区分颈内动脉真性闭塞与假性闭塞中的诊断价值，旨在为急性缺血性脑卒中患者的术前评估提供一种无创、高效的影像学方法。回顾性纳入47例CTA诊断为颈内动脉闭塞并同时接受4DCTP与DSA检查的患者，以DSA为金标准，评估4DCTP的诊断一致性。结果显示，4DCTP与DSA的一致率为80.9%，Kappa值为0.417 (P = 0.003)，具有中等程度一致性；其诊断灵敏度为82.5%，特异度为71.4%。研究表明，4DCTP基于CTP图像多时相重建，在不增加额外辐射的情况下，能有效识别颈内动脉假性闭塞，有助于介入医生在术前更准确地判断病变性质与部位，从而优化手术方案，改善患者预后。

Abstract: This study aimed to evaluate the diagnostic value of 4DCTP in distinguishing between true occlusion and pseudo-occlusion of the internal carotid artery, providing a non-invasive and efficient imaging method for preoperative assessment in patients with acute ischemic stroke. A retrospective analysis was conducted on 47 patients diagnosed with internal carotid artery occlusion by CTA who underwent both 4DCTP and DSA examinations. Using DSA as the gold standard, the diagnostic consistency of 4DCTP was evaluated. The results showed an agreement rate of 80.9% between 4DCTP and DSA, with a Kappa value of 0.417 (P = 0.003), indicating moderate consistency. The sensitivity and specificity of 4DCTP were 82.5% and 71.4%, respectively. The study demonstrates that 4DCTP, based on multi-phase reconstruction of CTP images without additional radiation, can effectively identify carotid artery pseudo-occlusions. This aids interventional physicians in more accurately assessing the nature and location of lesions before surgery, thereby optimizing surgical planning and improving patient outcomes.