本文選題：急性缺血性腦卒中　切入點：顱內出血　出處：《實用醫(yī)學雜志》2017年15期 　論文類型：期刊論文

【摘要】：目的探討雙源雙能量CT在鑒別急性缺血性腦梗死血運重建術后碘造影劑外滲和繼發(fā)腦出血中的價值。方法 46例因急性缺血性腦卒中行動脈內溶栓治療的患者納入本研究,于動脈溶栓術后2 h內行雙源雙能量CT檢查(80 k V/392 m A和140 k V/196 m A),利用圖像工作站生成融合圖像(即:單純融合圖像診斷法)、融合圖像加虛擬平掃圖像和碘疊加圖像(即:疊加融合圖像診斷法);術后48 h行常規(guī)CT平掃明確診斷。計算兩種診斷方法診斷繼發(fā)腦出血的敏感性、特異性、陽性預測值、陰性預測值和準確率。結果 34例得到確診的病例中6例患者CT未見明顯高密度影,余下28例為陽性病例并達到確診,其中3例出血,21例造影劑外滲,余下4例同時合并出血和造影劑外滲。單純融合圖像法對出血診斷的敏感性、特異性、陽性預測值、陰性預測值和準確率分別為66.67%、100%、100%、96.15%和96.43%,疊加融合圖像診斷法診斷的敏感性、特異性、陽性預測值、陰性預測值和準確率分別為100%%、96%、75%、100%和96.43%。疊加融合圖像對顱內出血、造影劑外滲及出血合并造影劑外滲的診斷準確性均相對較高,且差異具有統計學意義(P0.046)。疊加融合圖像的診斷準確性與臨床隨訪確診具有較高的一致性(Kappa=0.815),明顯高于單純融合圖像(Kappa=0.564)。結論雙源雙能量CT在鑒別顱內出血和造影劑外滲方面有著重要的臨床應用價值。
[Abstract]:Objective to investigate the value of dual-source and dual-energy CT in differentiating iodine contrast agent exosmosis from secondary cerebral hemorrhage after acute ischemic cerebral infarction after revascularization. Methods 46 patients with acute ischemic stroke underwent intra-arterial thrombolytic therapy. Within 2 hours after thrombolysis, double source and dual energy CT were performed to examine 80kV / 392mA and 140kV / 196mAn respectively. Fusion images were generated by image workstation (i.e., simple fusion image diagnosis method, fusion image plus virtual plain scan image and iodine stack). After 48 hours of operation, conventional CT plain scan was performed to make a definite diagnosis. The sensitivity of the two diagnostic methods in the diagnosis of secondary intracerebral hemorrhage was calculated. Results among 34 confirmed cases, 6 cases had no obvious high density image on CT, the remaining 28 cases were positive cases, and 21 cases had extravasation of contrast media, among which 3 cases had bleeding and 21 cases had extravasation of contrast media. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the fusion image method for diagnosis of hemorrhage were 66. 67% and 96. 43%, respectively. The diagnostic sensitivity of the superimposed fusion image method was 96. 15% and 96. 43%, respectively. The specificity, positive predictive value, negative predictive value and accuracy were 100% and 96.43%, respectively. The diagnostic accuracy of superimposed fusion images on intracranial hemorrhage, contrast media exosmosis and bleeding combined with contrast media exosmosis was relatively high. The difference was statistically significant (P 0.046). The diagnostic accuracy of superimposed fusion images was higher than that of simple fusion images. Conclusion Dual-source and dual-energy CT can distinguish intracranial hemorrhage from contrast media. Infiltration has important clinical application value.
【作者單位】： 天津醫(yī)科大學第二醫(yī)院;
【基金】：天津市衛(wèi)生局科技基金項目(編號:2013KZ101)
【分類號】：R743.33

【相似文獻】

相關期刊論文 前10條

1 龍朝霞;陸曉燕;;造影劑外滲的預防和處理[J];中國社區(qū)醫(yī)師(綜合版);2006年19期

2 劉暉;;造影劑外滲的預防及正確處理[J];中國傷殘醫(yī)學;2013年09期

3 譚法亮;造影劑外滲致上肢嚴重水腫二例[J];實用醫(yī)學影像雜志;2003年04期

4 張兆鋒;陳海曦;沈尊理;;碘造影劑外滲損傷的預防和治療進展[J];中國醫(yī)學影像學雜志;2009年06期

5 張小萍;姚永歡;梁少萍;司徒啟嬌;;乳腺癌術后CT檢查造影劑外滲的預防和護理[J];當代醫(yī)學;2011年26期

6 朱俊芳;劉建平;;預防造影劑外滲的體會[J];中國衛(wèi)生產業(yè);2011年07期

7 黃麗;;1例云南白藥聯合地塞米松外敷治療造影劑外滲的護理[J];當代護士(中旬刊);2012年03期

8 李愛霞;錢德英;;10例造影劑外滲病人的護理[J];全科護理;2012年30期

9 許小曼;程秀華;屈靜林;曹金紅;;醫(yī)療失效模式與效應分析在造影劑外滲風險管理中的應用[J];護理管理雜志;2013年06期

10 吳寧;;淺談造影劑外滲的預防及護理[J];中國衛(wèi)生產業(yè);2014年03期

相關會議論文 前1條

1 張莉;;強化CT檢查時造影劑外滲的預防和處理[A];全國腫瘤護理學術交流暨專題講座會議論文匯編[C];2008年

，

本文編號：1650180