本文關(guān)鍵詞： CT腦灌注 腦出血 預(yù)測(cè) 卒中　出處：《首都醫(yī)科大學(xué)學(xué)報(bào)》2017年01期 　論文類型：期刊論文

【摘要】：目的 評(píng)價(jià)急性腦出血血腫內(nèi)計(jì)算機(jī)斷層掃描灌注原始圖像(computed tomography perfusion source images,CTP-SI)上,動(dòng)態(tài)進(jìn)行性強(qiáng)化灶(“動(dòng)態(tài)點(diǎn)征”)對(duì)腦出血增長(zhǎng)的預(yù)測(cè)價(jià)值。方法 前瞻性研究112例連續(xù)性急性自發(fā)性腦出血病人,癥狀發(fā)生6 h以內(nèi),均接受電子計(jì)算機(jī)斷層掃描(computed tomography,CT)平掃及CTP檢查。檢查影像資料經(jīng)2位有經(jīng)驗(yàn)的神經(jīng)放射醫(yī)師進(jìn)行觀察評(píng)估。根據(jù)病人是否出現(xiàn)“動(dòng)態(tài)點(diǎn)征”分為2組。將臨床資料和影像資料相對(duì)應(yīng)分組,對(duì)“動(dòng)態(tài)點(diǎn)征”對(duì)腦出血血腫增長(zhǎng)預(yù)測(cè)進(jìn)行多變量評(píng)估分析。結(jié)果 112例病人中,經(jīng)復(fù)查證實(shí)腦出血增長(zhǎng)病人為28例(25.0%)。出現(xiàn)CTP-SI上強(qiáng)化灶為30例(26.8%)。強(qiáng)化組與無(wú)強(qiáng)化組的基線臨床數(shù)據(jù)相同,CTP“動(dòng)態(tài)點(diǎn)征”陽(yáng)性的病人中,25例(83.3%)病人表現(xiàn)為腦血腫增長(zhǎng),而5例(16.7%)病人無(wú)血腫增長(zhǎng)。“動(dòng)態(tài)點(diǎn)征”預(yù)測(cè)腦內(nèi)血腫增長(zhǎng)的靈敏度、特異度、陽(yáng)性預(yù)測(cè)值和陰性預(yù)測(cè)值分別為89.3%、94.0%、83.3%和96.3%,Kappa值為0.841(P0.001)。觀察者間的一致性高(κ=0.92)。經(jīng)單因素及多因素回歸分析,CTP“動(dòng)態(tài)點(diǎn)征”是具有獨(dú)立的預(yù)測(cè)腦內(nèi)血腫增長(zhǎng)的影像征象,其中單因素OR值為131.667(29.386~590.289)(P0.000 1);多因素分析OR值為230.996(32.123~1 295.448)(P0.000 1)。結(jié)論 CTP-SI中的“動(dòng)態(tài)點(diǎn)征”與急性腦出血血腫增長(zhǎng)有關(guān),是可用以臨床指導(dǎo)進(jìn)一步加強(qiáng)治療及監(jiān)護(hù)腦出血病人的有意義的影像學(xué)征象。
[Abstract]:Objective to evaluate computed tomography perfusion source imaging (CTP-SII) of computed tomography perfusion source in hematoma of acute intracerebral hemorrhage (AICH). Methods 112 consecutive patients with acute spontaneous intracerebral hemorrhage were studied prospectively. All the patients were examined by computed tomography CT and CTP. The imaging data were observed and evaluated by two experienced neuroradiologists. The patients were divided into two groups according to whether they had "dynamic dot sign" or not. The data and image data are grouped into groups, A multivariate evaluation analysis was made on the prediction of hematoma growth in intracerebral hemorrhage by "dynamic dot sign". Results among 112 patients, After reexamination, 28 patients with intracerebral hemorrhage growth were confirmed to have increased cerebral hemorrhage, and 30 patients with enhancement focus on CTP-SI were found to have the same baseline clinical data as that of non-enhancement group. 25 of the patients with positive "dynamic dot sign" were found to have increased cerebral hematoma. There was no hematoma growth in 5 patients. The sensitivity and specificity of "dynamic dot sign" in predicting the growth of intracerebral hematoma, The positive predictive value and negative predictive value were 89. 3% and 96. 3%, respectively, and the Kappa value was 0. 841% (P 0. 001). The consistency among observers was high (魏 0. 92). By single factor and multivariate regression analysis, CTP "dynamic dot sign" was an independent imaging sign for predicting the growth of intracerebral hematoma. The OR value of single factor was 131.66729. 386n 590.289. the OR value of multivariate analysis was 230.996 ~ 32.123.125.448% P0.00010.Conclusion the "dynamic dot sign" in CTP-SI is related to the increase of acute intracerebral hemorrhage hematoma. It is a useful imaging sign for clinical guidance to further strengthen the treatment and monitoring of patients with cerebral hemorrhage.
【作者單位】： 首都醫(yī)科大學(xué)附屬北京天壇醫(yī)院放射科北京市神經(jīng)外科研究所神經(jīng)影像室;
【分類號(hào)】：R445

【相似文獻(xiàn)】

相關(guān)會(huì)議論文 前2條

1 褚庭亮;王茂生;湯文杰;趙蕾;;基于網(wǎng)絡(luò)搜索的CTP主流技術(shù)分析實(shí)驗(yàn)報(bào)告[A];2008印刷版材發(fā)展技術(shù)論壇論文集[C];2008年

2 厲林堂;;更貼近普通用戶的CTP向您走來(lái)[A];2008印刷版材發(fā)展技術(shù)論壇論文集[C];2008年

相關(guān)重要報(bào)紙文章 前10條

1 特約嘉賓 楊方明;解讀進(jìn)口CTP機(jī)免關(guān)稅[N];中國(guó)新聞出版報(bào);2007年

2 肖暢;方正暢易CTP落戶北京外文印刷廠[N];中國(guó)新聞出版報(bào);2007年

3 龍金;東三省首臺(tái)方正報(bào)業(yè)雕龍CTP落戶佳木斯[N];中國(guó)包裝報(bào);2010年

4 本報(bào)記者 葉青;中科銀:讓中國(guó)CTP迎來(lái)春天[N];廣東科技報(bào);2009年

5 京生;海德堡第1000臺(tái)超霸CtP下線[N];中國(guó)包裝報(bào);2007年

6 梁紅兵;樂(lè)凱第二膠片廠：實(shí)現(xiàn)CTP版規(guī)模生產(chǎn)[N];中國(guó)電子報(bào);2007年

7 海朋;克里奧完全方案幫助中小印刷廠輕松實(shí)現(xiàn)CTP夢(mèng)想[N];中國(guó)包裝報(bào);2004年

8 記者 姚貞;燕京行網(wǎng)屏首度合作推出全新CTP[N];中國(guó)新聞出版報(bào);2007年

9 方明;聚酯版CTP———采用噴墨方案[N];中國(guó)包裝報(bào);2002年

10 ;康爾達(dá)創(chuàng)新CTP產(chǎn)品契合市場(chǎng)主流需要[N];中國(guó)包裝報(bào);2013年

相關(guān)碩士學(xué)位論文 前5條

1 肖洋;基于CTP流程的色彩與網(wǎng)點(diǎn)轉(zhuǎn)移特性分析[D];武漢大學(xué);2005年

2 余忠山;MELD評(píng)分和CTP分級(jí)對(duì)肝移植術(shù)后并發(fā)癥和死亡危險(xiǎn)因素分析以及對(duì)術(shù)后生存率預(yù)測(cè)的臨床研究[D];福建醫(yī)科大學(xué);2013年

3 賈澤博;門靜脈直徑聯(lián)合CTP分級(jí)在評(píng)價(jià)肝硬化患者預(yù)后的研究[D];新疆醫(yī)科大學(xué);2009年

4 王麗;噴墨CTP版用UV墨水的制備及性能研究[D];北京化工大學(xué);2006年

5 劉洋;超低劑量CT及CTP引導(dǎo)肺活檢的研究[D];河北醫(yī)科大學(xué);2014年

，

本文編號(hào)：1492974