头颅CT血管造影联合磁共振血管造影对短暂性脑缺血发作后卒中的预测价值

Value of cranial CT angiography combined with magnetic resonance angiography in prediction of transient ischemic stroke

  • 摘要: 目的 观察头颅CT血管造影(CTA)、磁共振血管造影(MRA)及两者联合应用对短暂性脑缺血发作后卒中的预测价值。 方法 选取收治的101例短暂性脑缺血患者为研究对象,入院时均接受头颅CTA与MRA检查,观察患者入院时的颅内动脉狭窄情况,并记录患者缺血发作后卒中发生情况。绘制受试者工作特征(ROC)曲线得到曲线下面积(AUC), 检验各影像学方法单独与联合应用预测短暂性脑缺血发作后卒中的价值。 结果 经诊断, 101例患者在住院治疗1周内发生缺血发作后卒中的患者15例; 经CTA、MRA结果显示,住院7 d内发生卒中的短暂性脑缺血患者颈动脉狭窄程度、颈动脉狭窄率均高于未发生卒中的患者,差异有统计学意义(P<0.05); CTA、MRA单独与两者联合检查检出的狭窄患者卒中发生率高于未检出狭窄者,差异有统计学意义(P<0.05); ROC曲线结果显示, CTA、MRA单独检查与两者联合检查在预测短暂性脑缺血发作后卒中的AUC分别为0.875、0.897、0.900, 且联合检查的AUC值较单独检查的预测价值高。 结论 入院时头颅CTA与MRA检查短暂性脑出血患者动脉狭窄情况可用于缺血发作后卒中风险预测,而联合检查的预测价值更高。

     

    Abstract: Objective To observe value of cranial CT angiography(CTA)and magnetic resonance angiography(MRA), as well as their combination in prediction of risk of stroke after cerebral ischemia. Methods A total of 101 patients with transient cerebral ischemia who admitted in the hospital were included. Cranial CTA and MRA examinations were performed for all patients on admission to observe the intracranial arterial stenosis conditions. The receiver operating characteristic curve(ROC)was drawn to obtain the area under the curve(AUC). The values of each imaging method alone and in combination in predicting transient ischemic stroke were examined. Results Out of 101 patients, there were 15 cases with ischemic stroke diagnosed as transient ischemic stroke within 1 week of hospitalization. The results of CTA and MRA showed that the degree of carotid artery stenosis and the rate of carotid artery stenosis within 7 d of hospitalization in patients with transient cerebral ischemia were higher than those without, and the difference was statistically significant(P<0.05). The incidence of stroke in patients with stenosis diagnosed by CTA or MRA alone and in combination was higher than that those without stenosis detected, and the difference was statistically significant(P<0.05). The ROC curve results showed that AUC of CTA and MRA alone and in combination in predicting the incidence of transient ischemic stroke was 0.875, 0.897, and 0.900, respectively, and the AUC value of combined prediction was higher than single prediction. Conclusion On admission, CTA and MRA detection of arterial stenosis can be used to predict the risk of ischemic stroke, and combined examination has higher predictive value.-

     

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