| Objective:To evaluate the clinical value of combined use of CT perfusion imaging(CTPI)and multi-slice CT angiography(MSCTA)in evaluation of ischemic stroke.Materials and Methods:41 patients underwent CTPI and MSCTA for suspected ischemic stroke.Patients were selected according to the inclusion and exclusion criteria.CTPI and MSCTA images of every patient who was included in the study were reviewed and evaluated by two radiologists independently.The MSCTA images were reviewed prospectively for presence and location of the stenosis and occlusion; CTP images were reviewed prospectively for regions of perfusion defect and emodynamic parameters to compare research regions with the counterparts,include of CBF,CBV,MTT and PS were reviewed.The sensitivity,specificity,accuracy, positive and negative predictive value,positive and negative likelihood ratio of combined use of CT perfusion imaging(CTPI)and multi-slice CT angiography (MSCTA)to diagnosis of ischemic stroke were calculated.The dependablity of carotid and cranial artery stenosis with intracranial perfusion defect were calculated. In addition,the value of PS in predicting hemorrhagic transformation of cerebral infarction were also calculatedResults:35 of 41 patients with carotid or cranial artery stenosis and/or perfusion defect were included in this study.40 areas of perfusion defect,17 segments of carotid artery and 31 segments of cranial artery stenoses were identified by CTPI and MSCTA.Multimodal CT findings revealed the sensitivity of MTT maps(96.3%)to diagnosis of ischemic stroke,and the highest specificity of unenhanced CT(100%) and CVB maps(100%).Compared with those of opposite side regions,Parameter values of CBF,CBV and MTT of perfusion defected areas were t=-9.644,t=-3.434,t=9.978,respectively,which showed statistical significance(P＜0.001).The correlation between perfusion parameter value changing and level of carotid or cranial artery showed that only the changing of MTT and stenosis of intracarotid artery had low dependablity(Pearson correlation coefficients r=0.524＞0.5,P=0.013), while other parameter had no significant correlation with stenosis of carotid or cranial artery.Perfusion data of group with hemorrhage and control group(without hemorrhage)of perfusion defected areas in follow-up CT imaging were compared.PS (t=6.588)and MTT(t=4.688)value of hemorrhage group showed significant deviation,had statistical significance(P＜0.001),was indicated.However,CBF and CBV did not show significant deviation,and no statistical significance was indicated.Conclusion:1.The presented multimodal CT evaluation improves detection rate of infarction in comparison with unenhanced CT,CT angiography,and perfusion CT alone.CTA imaging can show cerebrovascular stenosis and occlusion,determine the location of diseased region and measure the level of stenosis.Combined use of CT perfusion imaging(CTPI)and multi-slice CT angiography(MSCTA)can evaluate ischemic stroke with functional and morphological character and lend more theoretical support to clinical intervention.2.In this study,parameter changing(CBF, CBV and MTT)of perfusion defected areas all had significant deviation compared with that of opposite side,showed dynamic perfusion data could reflct cerebral hemodynamics more sensitively and exactly than other examination method.3.In this study,the statistic analysis of correlation between perfusion parameter value changing and level of carotid or cranial artery were undertaken.It turned out that only the changing of MTT and stenosis of intracarotid artery had low dependablity(Pearson correlation coifficient r=0.524＞0.5),while other parameters had no significant correlation with stenosis of carotid or cranial artery.4.In this study,PS value of group with hemorrhage compared with those of control group(without hemorrhage) of perfusion defected areas in follow-up CT imaging showed significant deviation, and indicated statistical significance,which revealed the ability of PS to calculate hemorrhagic transformation(HT)of ischemic stroke.
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