The Application Of Multi-mode CT In The Assessment Of Acute Ischemia Stroke

Acute ischemic stroke is the most common cerebrovascular disease,nowadays has become the leading cause of death in China.How to accurately assess the core of the infarction and the semi-dark band is the important basis for guiding the clinical choice of treatment.CTP(CT perfusion)provides multiparameter information of hemodynamics.Important information was given in predicting the infarction core and penumbra of patients with acute ischemic stroke,to a certain extent,and can predict relationship with the prognosis of patients.Objective:To investigate the value of multimodal CT in patients with acute ischemic stroke.To explore the correlation between the different scores of multimodality CT and the volume of final infarction and the prognosis of patients.Methods:Collect patients with acute ischemic stroke in the first hospital of jilin university from January 2016 to July 2017.According to the data collected,the data were divided into three parts.The first part was 234,and the time and prognostic data from the onset to CT scan and thrombolytic therapy were collected,and the correlation between time and prognosis was studied.The second part,53 people,collected multimodality CT,2-8 days of review CT scan or MRI scan data,mainly studied the CTP parameters for the infarction core and penumbra prediction.The third part,47 people,collected multimodality CT,patient general condition and prognosis data,mainly studies the correlation between CTP and prognosis.According to the prognosis of MRS score in 90 days,good functional outcome(mRS≤2)and poor outcome group(mRS>2)..The data was compiled with Excel2007 and SPSS22.0 software was used for statistical analysis.Results: 1.Part ⅠThrombolytic time is an main influencing factor affecting the prognosis.The longer of the thrombolytic time classification,the higher the risk of poor outcome(OR=1.175,95%CI 为 1.011~1.364)2.Part ⅡThere were significant differences in the CTP parameters between the infarcted core area,the penumbra and the infarct to the side(normal cerebral perfusion zone),all of which were statistically significant,P<0.01.The parameters determined by MTT,TTP,CBV,CBF ASPECTS are negatively correlated between ratings and review volume,ASPECTS of CBV parameter evaluation and review showed a negative correlation between volume,maximum correlation,correlation coefficient r =-0.683,with statistical significance(p < 0.05).The perfusion parameter MTT threshold increased by 45% compared with the MTT threshold increased by 90% and the final infarct volume was more accurate.3.Part ⅢThe age was positively correlated with the peak time of the artery,and the correlation coefficient r=0.397,which was statistically significant(p=0.001).The age was positively correlated with the peak time of the vein,and the correlation coefficient r=0.415,which was statistically significant(p<0.001).The age of patients with good prognosis was lower than those with poor prognosis(t=-2.175,p=0.035).The difference was statistically significant(t=-2.270,p=0.028).The CBV ASPECTS score in the good prognosis group was higher than that in the poor prognosis group,and the difference was statistically significant(t=2.728,p=0.010).