A Comparative Study Of Multimodal CT In Acute Cerebral Infarction Caused By Two Common Causes

Objective:To explore the characteristics of acute cerebral infarction(ACI)caused by two common causes in multimodal CT.Methods:Retrospective analysis of 42 patients with acute cerebral infarction,Among them,13 cases were in Cardioembolism(CE)group and 29 cases were in Atherosclerotic thrombosis(AT)group.General data,NIHSS score at admission/discharge,improvement rate of neurological function at discharge,infarction involving blood vessels,multi-segment embolus,the Regional Leptomeningeal Score,volume of hypoperfusion brain tissue,infarction core volume and ischemic penumbra volume were analyzed between the two groups.Statistical analysis was carried out.Results:1.There was no significant difference in gender and age between CE group and AT group.2.NIHSS score of CE group and AT group at admission was as follows:13(10,15)vs 10(5,18),NIHSS score of CE group and AT group at discharge was as follows:7(3,12)vs 6(1,12),improvement rate of neurological function at discharge was as follows:0.46(0.13,0.75)vs 0.30(0.06,0.58),(Z=-0.327?-0.027?-1.051,P>0.05),there was no statistical significance in the above differences.3.The proportion of infarction involving ACA,MCA and ICA terminals involved in infarction were[7.7%(1/13)?92.3%(12/13)?15.4%{2/13)]vs[6.9%(2/29).89.7%(26/29)?20.7%(6/29)],P>0.05,There was no statistical significance in the above differences.The proportion of multi-segmental embolus infarction in the two groups was 7.7%(1/13)vs 41.4%(12/29),P<0.05,the difference was statistically significant.The Regional Leptomeningeal Score between the two groups was 17(12,17)vs 18(16,19),P<0.05,the difference was statistically significant.Analysis of ROC curve showed that the threshold was 17.5,the area under the curve was 0.712,the sensitivity was 50.1%,and the specificity was 84.6%.4.The volume of low perfusion area and ischemic penumbra in CE group were larger than that in AT group[132(64,201)?73(35,99)]vs[72(11,157)?47(9,118)],(Z=-1.403?-0.872,P>0.05),there was no statistical significance in the above differences.The volume of core of infarction between the two groups was 57(13,84)vs 8(1,34),the difference was statistically significant(Z=-2.031,P<0.05).Analysis of ROC curve showed that the threshold was 10,the area under the curve was 0.698,the sensitivity was 84.6%,and the specificity was 51.7%.Conclusion:There were significant differences between CE group and AT group in multimodal CT evaluation results.The volume of core of infarction was higher in CE group,the incidence of multi-segmental embolus and Regional Leptomeningeal Score was higher in AT group.It is suggested that the volume of core of infarction?multi-segmental embolus and Regional Leptomeningeal Score are helpful in differentiating between patients with CE and AT.It has certain guiding significance for clinical etiology diagnosis and treatment.