| Objectives 1 To explore the evaluation value of computerized tomographic perfusion imaging combined with computerized tomographic angiography in the evaluation of the infarct core area,ischemic penumbra area and collateral circulation compensation in patients with acute ischemic stroke;2 To explore the correlation between the collateral circulation compensation status of AIS patients and the score of the national institutes of health stroke scale on admission and after admission,and the consistency of the stenosis of the angiographic lumen with the evaluation of digital subtraction angiography.Methods Retrospectively collected on June 6,2019 to 2020,10 menstrual GE Revolution of CT diagnosis of AIS patients to our hospital because of headache,hemiplegia,and CTP combination CTA scan technology,two assessed according to the CTA evaluation of compensatory collateral circulation conditions for phase comparison results of consistency,and compensatory collateral circulation in patients with selected grouping,the collateral circulation score of 4 to 5 points of AIS patients divided into state compensatory collateral circulation well group,total 72 patients enrolled in the study,the following four points can be divided into state compensatory collateral circulation undesirable group,a total of 36 patients were included in this study.The correlation between cerebral blood flow,cerebral blood volume,mean transit time,time to maximum of residual function and the side of perfusion defect was analyzed,and the correlation between the relative perfusion parameters and collateral circulation compensating state was also analyzed.The relationship between collateral circulation and NIHSS scores of AIS patients after admission was analyzed.The degree of stenosis of the vascular lumen was classified according to mild stenosis,moderate stenosis,severe stenosis and occlusion by CTA.The consistency of the assessment of the degree of vascular lumen stenosis was compared between CTA and DSA.Results A total of 108 AIS patients were collected in this study,including 66 male patients and 42 female patients.According to the degree of compensatory effect of multiphase CTA on collateral circulation,the analysis results of the two evaluators on the collateral circulation of AIS patients had a high consistency(Kappa value =0.839).In the analysis of cerebral perfusion parameters,the infarction core area on the side of the perfusion defect was compared with the ischemic penumbra area,and the differences among the perfusion parameters were statistically significant(P < 0.01).The decrease of CBF and CBV was more significant,and the extension of MTT and Tmax was more obvious.Compared with the core area of infarction on the perfusion defect side and the mirror area on the healthy side,the difference of each perfusion parameter was statistically significant(P < 0.01),CBF and CBV were significantly decreased,MTT and Tmax were significantly prolonged.Compared with the mirror area on the healthy side,the difference of perfusion parameters CBF,MTT and Tmax in the ischemic penumbra on the side of the perfusion defect was statistically significant(P < 0.01),CBF decreased and MTT and Tmax prolonged,but compared with the perfusion parameter CBV and the mirror area on the healthy side,the difference was not statistically significant(P > 0.05).The relative cerebral perfusion parameters analysis showed that compared with the relative cerebral perfusion parameters of the infarction core area in the poor collateral circulation compensation group,the differences of the relative cerebral perfusion parameters were statistically significant(P < 0.05),the r CBF and r CBV were decreased,and the r MTT and r Tmax were prolonged.Relative perfusion parameters r CBF,r MTT and r Tmax showed statistically significant differences in the group with poor collateral circulation compensation compared with the group with good collateral circulation compensation compared with the group with good collateral circulation compensation.r CBF decreased while r MTT and r Tmax were prolonged,but there was no statistically significant difference in the relative perfusion parameters r CBV compared with the group with good collateral circulation compensation(P > 0.05).For AIS patients,compared with the poor group at admission,7 d,14 d and 90 d of follow-up,there were statistically significant differences in NIHSS scores between the two groups(P < 0.01).Using CTA and DSA technology to display the vascular anatomy,through a review of luminal stenosis,26 patients with mild stenosis in patients with AIS,22 patients with moderate stenosis,24 patients with severe stenosis and 20 patients with occlusion in performance evaluation results are consistent,CTA and DSA technology in the assessment of vascular luminal stenosis with high consistency(Kappa value = 0.802),statistically significant difference(P< 0.01).Conclusions 1 The perfusion parameter values obtained by CTP technology can effectively evaluate the infarct core area and the ischemic penumbra area of the brain tissue,and through the analysis of the relative perfusion parameter values of CTP,the collateral circulation of the brain tissue can be compensated early to evaluate the status and provide more effective basis to better guide the patient’s personalized treatment.2 The NIHSS scores of patients with AIS at admission,admission 7 days,14 days,and follow-up 90 days have a significant correlation with the collateral compensation status.The better the compensation status of collateral circulation,the lower the NIHSS score.Moreover,CTA and DSA examination techniques showed good consistency in the evaluation of the degree of vascular stenosis in the responsible vessels.Figure 9;Table 7;Reference 112... |
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