[1]吴长松,陈海新,李斌,等.双能CT早期鉴别急性缺血性脑卒中血管内治疗后脑出血的临床应用[J].中国临床神经外科杂志,2024,29(01):25-27.[doi:10.13798/j.issn.1009-153X.2024.01.008]
　WU Chang-song,CHENG Hai-xin,LI Bin,et al.Clinical application of dual-energy CT for early identification of intracranial hemorrhage after stent thrombectomy for acute ischemic stroke[J].,2024,29(01):25-27.[doi:10.13798/j.issn.1009-153X.2024.01.008]
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双能CT早期鉴别急性缺血性脑卒中血管内治疗后脑出血的临床应用()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
29
期数:
2024年01期
页码:
25-27
栏目:
论著
出版日期:
2024-01-30

文章信息/Info

Title:
Clinical application of dual-energy CT for early identification of intracranial hemorrhage after stent thrombectomy for acute ischemic stroke
文章编号:
1009-153X（2024）01-0025-03
作者:
吴长松; 陈海新; 李斌; 蒋悦; 王玛莉
650051昆明，昆明市延安医院神经外科（吴长松、钟剑烽、陈海新、李斌、王玛莉），医学影像科（蒋悦）
Author(s):
WU Chang-song1;  CHENG Hai-xin1;  LI Bin1;  JIANG Yue2;  WANG Ma-li1
1. Department of Neurosurgery, Kunming Yanan Hospital, Kunming 650051, China; 2. Department of Medical Iconography, Kunming Yanan Hospital, Kunming 650051, China
关键词:
急性缺血性卒中; 血管内介入治疗; 双能CT; 脑出血; 造影剂外渗
Keywords:
Acute ischemic stroke;  Intravascular interventional therapy;  Dual-energy CT;  Intracranial hemorrhage; Extravasation of contrast agent
分类号:
R 743; R 815.2
DOI:
10.13798/j.issn.1009-153X.2024.01.008
文献标志码:
A
摘要:
目的 探讨双能CT在急性缺血性脑卒中（AIS）病人血管内治疗后继发脑出血的诊断中价值以及指导临床治疗的意义。方法 回顾性分析2019年11月至2022年5月接受血管内治疗的148例急性缺血性卒中的临床资料。术后即刻行头颅双能去碘CT 扫描检查诊断脑出血；术后48~72 h内行CT平扫或MRI检查随访，以此结果为标准评价双能CT诊断AIS病人术后早期脑出血及造影剂外渗的敏感度、特异度、阳性预测值、阴性预测值和准确率。结果 148例中，29例双能CT平扫未见脑内高密度影，术后48~72 h复查无出血；119例CT平扫有高密度影，双能CT诊断为单纯碘造影剂外渗69例，其中4例复查有脑出血，阴性预测率为94.2%；双能CT诊断造影剂渗漏合并脑内出血50例中，43例有脑出血，阳性预测率为100.0%；7例复查未见出血，假阳性率为14.0%；预测总准确率为 92.6%。结论 AIS血管内介入术后双能CT检查对于早期鉴别脑出血与碘对比剂外渗有重要的诊断价值，有助于临床及时调整治疗方案，降低病死率及致残率。
Abstract:
Objective To investigate the value of dual-energy CT in the diagnosis of secondary cerebral hemorrhage after intravascular therapy in patients with acute ischemic stroke (AIS) and its significance of guiding clinical treatment. Methods The clinical data of 148 patients with AIS who received endovascular therapy from November 2019 to May 2022 were retrospectively analyzed. Intracerebral hemorrhage was examined by double-energy iodinated CT scan immediately after operation. The results of CT or MRI within 48~72 h after operation were used as the standard to evaluate the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of dual-energy CT in diagnosing early postoperative cerebral hemorrhage and contrast agent extravasation in AIS patients. Results Of these 148 patients, 29 patients’ dual-energy CT scan did not find intracerebral high-density imaging, without bleeding 48~72 hours after the reexamination. There were 119 patients with high density images on CT scan, 69 patients with pure iodine-contrast agent extravasation were diagnosed by dual-energy CT, of which 4 patients had cerebral hemorrhage after reexamination, the negative prediction rate was 94.2%. Of 50 patients with contrast leakage complicated with intracerebral hemorrhage diagnosed by dual-energy CT, 43 patients had intracerebral hemorrhage, the positive prediction rate was 100%. No bleeding was found in 7 patients, the false positive rate was 14%. The total prediction accuracy was 92.6%. Conclusions Dual-energy CT examination after AIS intravascular intervention has important diagnostic value for early differentiation of cerebral hemorrhage and iodide contrast extravasation, which is helpful to timely adjustment of clinical treatment and reduce the mortality and disability rates.

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备注/Memo

备注/Memo:
（2023-07-15收稿，2023-09-25修回）基金项目：昆明市医学技术中心卫生科研课题（2020-04-04-12）通讯作者：钟剑烽，E-mail：zjf1968@163.com
更新日期/Last Update: 2024-01-30