利用双能量 CT 鉴别缺血性中风的血栓类型。
IF 3.2
3区 医学
Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
引用次数: 0
摘要
目的本研究探讨了双能计算机断层扫描（DECT）在缺血性脑卒中血栓类型判别中的临床应用：方法：纳入在血栓切除术前接受脑 DECT 非对比扫描和脑 CT 灌注（CTP）的急性缺血性脑卒中患者，并通过术后病理分析血栓构成。DECT 数据用于重建多色图像和有效原子序数图像。测量并计算血栓的计算机断层扫描（CT）值、有效原子数和光谱曲线斜率。血栓的衰减增加可从 CTP 数据中获得。对以红细胞（RBC）为主的血栓和以纤维蛋白/血小板（F/P）为主的血栓进行了参数比较。分析了区分这些血栓的阈值、灵敏度、特异性和曲线下面积（AUC）。通过斯皮尔曼相关性分析了 DECT 参数与红细胞比例之间的关系：结果：对 42 例入选患者进行病理分析后发现，24 例血栓以 RBC为主，18 例血栓以F/P为主。与 F/P 型血栓组相比，RBC 型血栓组的有效原子数、光谱曲线斜率和多色图像 CT 值明显更高。虽然F/P为主血栓组的血栓平均衰减增加较多，但这一差异在统计学上并不显著。在 DECT 参数中，多色图像 CT 值的 AUC 最大，为 0.924（0.848-0.999），用于区分 RBC 主导血栓和 F/P 主导血栓，阈值为 59 HU，灵敏度为 79.2%，特异性为 94.4%。综合诊断 AUC 达到 0.938（0.863-1.012），灵敏度为 87.5%，特异度为 94.4%。DECT 多色图像 CT 值、有效原子数和光谱曲线斜率与红细胞比例显著相关（r = 0.673、0.574 和 0.571，均为 p 结论：DECT 多色图像 CT 值、有效原子数和光谱曲线斜率与红细胞比例显著相关（r = 0.673、0.574 和 0.571，均为 p）：DECT 非对比扫描参数与血栓组成相关，可有效区分 RBC 主导型血栓和 F/P 主导型血栓。本文章由计算机程序翻译，如有差异，请以英文原文为准。
Discrimination of thrombus types in ischemic stroke using Dual-Energy CT
Objective
This study explores the clinical utility of dual-energy computed tomography (DECT) in discriminating thrombus types in ischemic stroke.
Methods
Patients with acute ischemic stroke who underwent brain DECT non-contrast scanning and brain CT perfusion (CTP) before thrombectomy were included, and the thrombus composition was analyzed by postoperative pathology. DECT data was conducted to reconstruct polychromatic images and effective atomic number images. Computed tomography (CT) values, effective atomic numbers, and spectral curve slopes of the thrombus were measured and calculated. Thrombus attenuation increase was obtained from CTP data. Parameters were compared between red blood cell (RBC)-dominant thrombi and fibrin/platelet (F/P)-dominant thrombi. Thresholds, sensitivity, specificity, and area under the curve (AUC) were analyzed to distinguish these thrombi. The associations between DECT parameters and proportion of RBCs were analyzed by Spearman’s correlation.
Results
Pathological analysis of 42 enrolled patients revealed 24 cases of RBC-dominant thrombi and 18 cases of F/P-dominant thrombi. Effective atomic numbers, spectral curve slopes, and polychromatic images CT values were significantly higher in the RBC-dominant thrombi group compared with the F/P-dominant thrombi group. Although the average thrombus attenuation increase was greater in the F/P-dominant thrombi group, this difference was not statistically significant. Among the DECT parameters, polychromatic images CT values had the greatest AUC at 0.924 (0.848–0.999) for discriminating RBC-dominant and F/P-dominant thrombi, with a threshold of 59 HU, sensitivity of 79.2 %, and specificity of 94.4 %. The combined diagnostic AUC reached 0.938 (0.863–1.012), with 87.5 % sensitivity and 94.4 % specificity. DECT polychromatic images CT values, effective atomic numbers, and spectral curve slopes were significantly correlated with proportion of RBCs (r = 0.673, 0.574, and 0.571, all p < 0.01).
Conclusion
DECT non-contrast scan parameters are associated with thrombus composition, which could be effective in distinguishing between RBC-dominant and F/P-dominant thrombi.
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来源期刊
CiteScore
6.70
自引率
3.00%
发文量
398
审稿时长
42 days
期刊介绍：
European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field.
Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.
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