CTP联合DWI对短暂性脑缺血发作患者继发脑梗死的预测价值分析OA

Objective To investigate the predictive value of CT perfusion(CTP)combined with magnetic resonance diffusion weighted imaging(DWI)for secondary cerebral infarction(CI)in patients with transient ischemic attack(TIA).Methods The clinical data of 100 TIA patients diagnosed and treated at the First People's Hospital of Longquanyi District Chengdu from February 2020 to December 2023 were retrospectively analyzed.All patients underwent CTP and DWI examinations within 24 hours of admission.Based on the occurrence of secondary CI within a 90-day follow-up,patients were divided into a CI group(27 cases)and a non-CI group(73 cases).Parameters including cerebral blood volume(CBV),cerebral blood flow(CBF),mean transit time(MTT),time to maximum(Tmax),and apparent diffusion coefficient(ADC)were compared.A Logistic regression model was used to identify parameters predictive of secondary CI after TIA,and predictive models based on CTP parameters alone and the combination of CTP and DWI were established.ROC curve analysis was performed to evaluate the AUC,sensitivity,and specificity of MTT,Tmax,ADC,the combined CTP model,and the combined CTP-DWI model in predicting secondary CI in patients with TIA.Results There were statistically significant differences in the number of TIA episodes,duration of TIA symptoms,and ABCD2 scores between the CI and non-CI groups(χ2=5.085,5.463,10.405;all P<0.05).The CI group had lower CBV,CBF,and ADC value but higher MTT and Tmax compared to the non-CI group(t=4.162,3.153,5.819,5.190,3.895;all P<0.05).Logistic regression analysis identified MTT,Tmax,and ADC value as influence factors of secondary CI(all P<0.05).ROC curve analysis showed that the AUCs for MTT,Tmax,ADC value,the combined CTP model,and the combined CTP-DWI model in predicting secondary CI were 0.784,0.716,0.815,0.800,and 0.949,respectively.The AUC of the combined CTP-DWI model was significantly higher than those of MTT,Tmax,ADC value,and the combined CTP model alone(Z=-2.942,-3.612,-2.800,-2.453;all P<0.05).Conclusion Both CTP and DWI have value in predicting secondary CI in TIA patients,but their combination demonstrates significantly higher predictive efficacy.