The Evaluated Prognosis Value Of CT Perfusion Imaging In Patients With Acute Cerebral Infarction

Objective:To analyze the relationship between the various parameters of CT perfusion imaging（CTPI）and the clinical prognosis of patients with acute cerebral infarction undergoing only conventional medical treatment.Methods:To collect the general relevant data of patients with acute cerebral infarction diagnosed within 24 hours and without arterial thrombectomy or intravenous thrombolysis within24 hours of the onset of our hospital from October 2019 to January 2021.Using NIHSS（National Institute of Health strokescale）as the evaluation index of clinical neurological deficit,evaluation at the onset of the disease,patients with a score of between 4 and 25 were selected as enrolled cases.Using a modified Rankin scale（modified Rankin Scale,Them RS）was followed up at 90 days of onset,to evaluate their prognostic functional disability level.The m RS≤2 was included in the good-prognosis group,the m RS≥3 was the worse prognosis group.All the enrolled cases had improved CTPI within 24 h of onset,and the CTPI parameters were recorded and analyzed respectively,including MTT（Mean Transit Time）,TTP（Time To Peak）,CBF（Cerebral Blood Flow）and CBV（Cerebral Blood Volume）parameters on the lesion side and the healthy side at the same lesion level.Moreover,thepotentialcorrelationbetweenchangesof CTPIparametersattheaffectedsi deand the prognosis of patients with acute cerebral infarctioninfarction was analyzed,and which of the four CTPI parameters had the most significant prognostic potential in acute cerebral infarction was explored as well,so that the prognosis of acute cerebral infarction could be predicted as early as possible in clinical practice.Results:A total of 76 cases were included,including 40 cases in the poor prognosis group and 36 cases in the good prognosis group.Between the two groups of age、on admission of the NHISS score statistical differences（P < 0.05）,gender,history of hypertension,diabetes,history of drinking,smoking history,history of hyperlipidemia,experiment treatments such as related to data in were not statistically significant（P > 0.05）,see table 1.In the poor prognosis group,CBV and CBF of the affected side were lower than those of the healthy side,while MTT and TTP were longer than those of the healthy side,with statistical significance（P<0.05）,as shown in Table 2.In the group with good prognosis,CBV and CBF of the affected side were lower than those of the healthy side,while MTT and TTP were longer than those of the healthy side,with statistical significance（P<0.05）.See Table 3 for details.CBV and CBF in the poor prognosis group were lower than those in the good prognosis group,while MTT and TTP were longer than those in the good prognosis group,with statistical significance（P<0.05）.There was no statistically significant difference in all parameters of the healthy side between the two groups（P>0.05）,as shown in Table 4.It can be seen that all CTP parameters are related to the prognosis of acute cerebral infarction,and CBF parameter is more accurate in predicting the prognosis of acute cerebral infarction,which directly affects the prognosis of acute cerebral infarction.Every 1 unit increase in CBF,the probability of good prognosis of patients increases by 2.1%,as shown in Table 5.Conclusions:1.CBV,CBF,TTP and MTT parameters of CT perfusion imaging are correlated with the prognosis of acute cerebral infarction,and may be used as prognostic indicators for patients with acute cerebral infarction.2.Among the four parameters of CT perfusion imaging,CBF parameter is the most important parameter affecting the prognosis of cerebral infarction,which can directly reflect the prognosis of acute cerebral infarction in the early clinical stage,that is,for every unit of CBF increase,the probability of good patient prognosis increases by 2.1%,which is also the most meaningful parameter to predict the prognosis of acute cerebral infarction among the four parameters.3.The changes of CBV,CBF,TTP and MTT parameters in CT perfusion imaging are all correlated with the occurrence of acute cerebral infarction,which is consistent with the current mainstream research that CTPI examination can help diagnose the occurrence of acute cerebral infarction.