目的:本研究旨在评估基于双能量计算机断层扫描(DECT)的X-Map重建在急性缺血性卒中(AIS)中的诊断价值。
方法:从11月开始住院的66例疑似AIS患者,2021年至4月,2022年为回顾性选择。DECT,CT灌注成像(CTP),CT血管造影(CTA),和MRI均在症状出现后24小时内进行。作为诊断AIS的黄金标准,根据MRI弥散加权成像阳性结果,共有53例患者被诊断为AIS.采用卡方检验评价X-Map对AIS的诊断效能,CTP,还有CTA.
结果:在53例确诊的ASI患者中,共检出72个病灶,包括额叶(n=33),顶叶(n=7),颞叶(n=12),基底神经节区(n=12),丘脑(n=3),和pons(n=5)。X-Map对AIS的病例检出率与CTP相似(p=0.151),但明显高于CTA(p<0.001)。在诊断效能方面,在总共66名患者中,X-Map实现了比CTP和CTA更高的诊断灵敏度(85%)。然而,在所使用的诊断工具中,CTP取得了最佳的诊断特异性(84.6%)和诊断准确性(77.4%)。
结论:与CTA和CTP相比,X-Map为AIS的诊断提供了更好或相等的临床价值。分别,强调其在临床应用中的潜力。
This study aimed to evaluate the diagnostic value of X-Map reconstruction based on Dual-Energy Computed Tomography (DECT) in acute ischemic stroke (AIS).
Sixty-six cases of suspected AIS patients hospitalized from November, 2021 to April, 2022 were retrospectively selected. DECT, Computed Tomography Perfusion imaging (CTP), Computed Tomography Angiography (CTA), and MRI were all performed within 24 hours after symptom onset. As the gold standard for diagnosing AIS, a total of 53 patients were diagnosed with AIS based on the diffusion-weighted imaging positive results in MRI. The Chi-square test was used to evaluate the diagnostic efficacy of AIS among X-Map, CTP, and CTA.
In the 53 patients with confirmed ASI, a total of 72 lesions were detected, including in the frontal lobes (n=33), parietal lobes (n=7), temporal lobes (n=12), basal ganglia regions (n=12), thalamus (n=3), and pons (n=5). The case detection rate of X-Map for AIS was similar to that of CTP (p=0.151) but was significantly higher than that of CTA (p<0.001). In terms of diagnostic efficacy, among the total 66 patients enrolled, X-Map achieved a higher diagnostic sensitivity (85%) than CTP and CTA. However, CTP achieved the best diagnostic specificity (84.6%) and diagnostic accuracy (77.4%) among the diagnostic tools used.
X-Map provides a better or equal clinical value for the diagnosis of AIS as compared to CTA and CTP, respectively, highlighting its potential in clinical applications.