The Application Of Multi-mode CT In Acute Ischemia Stroke

Objective:To investigate the application of multi-modal CT in patients with acute ischemic stroke,and to explore the correlation between the different scores of multi-modal CT and the final infarct core,and to assess its predictive value in predicting the prognosis of the patients with non conservative treatment.Methods:The patients with acute ischemic stroke who were treated in the Department of Neurology from December 2015 to December2016 were collected.Multi-modal CT examination,including CT scan,CTP and CTA,were performed in all patients,and follow-up imaging was performed on all patients,either with the same CT scanner or by using a MR imaging scanner within one week after the onset.CT scan ASPECTS,CTP ASPECTS and follow up imaging ASPECTS were analyzed on all patients.The patients were divided into conservative treatment and non conservative treatment according to the treatment options.According to the outcome of patients with non conservative treatment were divided into two groups: good functional outcomegroup(m RS ≤ 2)and poor outcome group(m RS>2).Correlation coeffiient was calculated with Spearman p Signifiance level was0.05.Between groups,comparisons for variables were made with Mann–Whitney U test.We measured the area under the receiver operating characteristic curve(AUC-ROC)of two scoring systems and compared the prediction of good functional outcome(defined as m RS 0-2)by pairwise comparison of ROC curves.Results:Sixty-seven patients were included in the study.Thirty-seven cases with conservative treatment,and thirty cases with non conservative treatment.There are 49 cases were male,and 18 were female.The average age of 61.7 years(42~83).The median(min-max)scores of ASPECT on CT scan,CTP and follow-up imaging were 8.7(2~10),8.2(1~10),6.8(1~10).In patients with conservative treatment,the ASPECTS Of CT scan And CTP were positively correlated with the ASPECTS of follow-up imaging,which were statistically significant.In patients with none conservative treatment,the ASPECTS of CT scan And CTP were positively correlated with the ASPECTS of follow-up imaging,which were statistically significant.In the good functional outcome group and poor functional outcome group,the differences werestatistically significant,P<0.05.Comparison of different prediction effect on the prognosis of the patients with none conservative treatment,the area of CTP under the ROC curve,AUC=0.787,CT scan AUC=0.741.Conclusion:(1)The ASPECTS of multi-modal CT can help assess the final infarct core in patients with AIS.(2)The imaging findings of multi-modality CT can help predict the prognosis of patients with none conservative treatment AIS.(3)The application of multi-modal CT can help the early diagnosis of acute ischemic stroke,assess the disease and judge the prognosis,which can guide the choose of clinical treatment.