Abstract: Objective To explore the application value of 4D-CT Temporary average reversal imaging in the diagnosis of ischemic stroke. Methods A retrospective analysis was conducted on 60 cases of clinically suspected ischemic stroke.CT perfusion and magnetic resonance DWI scans were performed, and CTP scan data were analyzed using 4D-CT analysis software combined with Temporary average inversion images.The location and number of infarcted lesions were recorded, and the results of magnetic resonance DWI examination were used as the standard.Kappa test was used to evaluate the results of 4D-CT Temporary average inversion images, CTP diagnosis, and joint analysis, and then compared with whether the results were consistent with magnetic resonance DWI examination. Results The number and location distribution of acute ischemic infarction lesions were detected in 60 patients.DWI examination detected a total of 108 lesions, including 88 in the anterior circulation area(81.48%) and 20 in the posterior circulation area(18.52%);The CTP analysis results showed 48 locations and 45 anterior circulation areas, with average consistency, sensitivity of 41.67%, and specificity of 97.78%.There are 3 locations in the posterior circulation zone, with poor consistency, sensitivity of 41.67%, and specificity of 100%;A total of 96 locations were displayed on 4D-CT Temporary average inversion images, including 79 locations in the anterior circulation area, with high consistency, sensitivity of 89.78%, and specificity of 91.14%.There are 17 locations in the posterior circulation area, with high consistency, sensitivity of 94.44%, and specificity of 93.02%;The combination of two methods can improve the detection of lesions in the anterior circulation area, with a sensitivity of 94.32% and a specificity of 96.39%. Conclusion The combination of CTP and 4D-CT Temporal average inversion imaging analysis can improve the detection rate of positive lesions in ischemic stroke, especially with higher value in the posterior circulation area.

Key words: CTP, Brain tissue, Cerebrovascular, Ischemic cerebral infarction, Temporary average inverted image

摘要： 目的 探讨4D-CT Temporal average反转像在缺血性脑卒中诊断中的应用价值。方法 回顾性分析60例临床怀疑缺血性脑梗死,进行CT灌注、磁共振DWI扫描,将CTP扫描数据采用4D-CT分析软件联合Temporal average反转像,并记录梗死灶显示位置及数量,以磁共振DWI检查显示结果为标准,采用Kappa检验评价4D-CT Temporal average反转图、CTP诊断的结果及联合分析结果,再与磁共振DWI检查是否一致进行对比。结果 60例患者在急性缺血性梗死灶检出数量及位置分布,DWI检查共检出108处,其中前循环区88处(81.48%),后循环区20处(18.52%);CTP分析结果显示48处,前循环区45个,一致性一般,灵敏度41.67%,特异度97.78%。后循环区3处,一致性差,灵敏度41.67%,特异度100%;4D-CT Temporal average反转像共显示96处,其中前循环区79处,一致性较高,灵敏度89.78%,特异度91.14%。后循环区17处,一致性高,灵敏度94.44%,特异度93.02%;联合应用两种方法可提高前循环区病灶检出,灵敏度94.32%,特异度96.39%。结论 CTP联合应用4D-CT Temporal average反转像分析可提高缺血性脑卒中阳性病灶检出率,尤其对脑后循环区具有更高价值。

关键词: CTP, 脑组织, 脑血管, 缺血性脑梗死, Temporal average反转像