中国临床医学影像杂志  2018, Vol. 29 Issue (9): 609-611    DOI: 10.12117/jccmi.2018.09.001
  中枢神经影像学 本期目录 | 过刊浏览 | 高级检索 |
超急性期脑梗死大脑中动脉高密度征的综合分析
林惠花1,王瑞芳2,宁清灵1,徐志华1,杨本强3,张梦知1,蔡晓楠3,侯  洁1,段  阳3
1. 锦州医科大学 中国人民解放军沈阳军区总医院研究生培养基地,辽宁 沈阳  110016;
2. 武警辽宁总医院放射科,辽宁 沈阳  110034;3. 中国人民解放军沈阳军区总医院放射科,辽宁 沈阳  110016
Comprehensive analysis of the high density of middle cerebral artery sign in hyperacute cerebral infarction
LIN Hui-hua1, WANG Rui-fang2, NING Qing-ling1, XU Zhi-hua1, YANG Ben-qiang3,#br# ZHANG Meng-zhi1, CAI Xiao-nan3, HOU Jie1, DUAN Yang3
1. Jinzhou Medical University, General Hospital of Shenyang Military Region Command Training Base for Graduate,
Shenyang 110016, China; 2. Department of Radiology, Liaoning General Hospital of Armed Police, Shenyang 110034, China;
3. Department of Radiology, General Hospital of Shenyang Military Region Command of PLA, Shenyang 110016, China
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摘要 目的:综合分析非增强CT(NECT)图像单侧大脑中动脉高密度征(HMCAS),初步探索超急性期脑梗死患者单侧HMCAS识别的客观指标。方法:回顾性分析116例超急性期脑梗死患者,由两位观察者对HMCAS识别进行观察者内与观察者间重复性分析(Kappa分析)。通过ROC曲线确定超急性期脑梗死患者大脑中动脉(MCA)近段CT值与CT值比值(患侧/健侧)的最佳阈值,分析HMCAS识别的灵敏度及特异度。结果:观察者内与观察者间对HMCAS主观识别具有高度重复性(K值0.82、0.86),结合临床病史,重复性更佳(K值0.95)。CT值≥40 HU、CT值比值(患侧/健侧)≥1.2为HMCAS识别的最佳阈值,且灵敏度(91.23%)与特异度(100%)相对其他标准最高。结论:结合临床病史及CT值变化,可以有效识别HMCAS;MCA近段CT值≥40 HU、CT值比值(患侧/健侧)≥1.2为最佳阈值。
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关键词 脑梗塞;大脑中动脉;体层摄影术螺旋计算机    
Abstract:Objective: To explore objective criteria which are suitable for clinical application by comprehensive analysis of unilateral hyperdense middle cerebral artery sign(HMCAS) on non-enhanced computed tomography(NECT). Methods: One hundred sixteen patients with hyperacute cerebral infarction were retrospectively evaluated. The presence of HMCAS was evaluated between inter- and intra-observers. K value was calculated. The cut off value of MCA attenuation and MCA ratio(the affected side/the healthy side) in the HMCAS(+) and HMCAS(-) was measured through the ROC curve in all patients with hyperacute cerebral infarction. The sensitivity and specificity was analyzed. Results: The interobserver and intraobserver agreement were substantial(K value of 0.82 and 0.86, respectively) and increased to almost perfect(K value of 0.95) when the reader was provided with clinical information. MCA attenuation≥40 HU and MCA ratio≥1.2 was the best threshold for HMCAS recognition. When both MCA attenuation≥40 HU and MCA ratio≥1.2 were satisfied, sensitivity(91.23%) and specificity(100%) were the highest relative to other standards. Conclusion: It is effective and feasible to evaluate the unilateral HMCAS on NECT images by combining with clinical history. MCA attenuation≥40 HU and MCA ratio≥1.2 was the best threshold for HMCAS recognition, which is suitable for application in daily clinical practice.
Key wordsBrain infarction    Middle cerebral artery    Tomography, spiral computed
收稿日期: 2017-10-12     
PACS:  R743.3  
  R814.42  
基金资助:辽宁省自然科学基金计划项目(No.201602768)。
通讯作者: 段阳,中国人民解放军沈阳军区总医院放射科,110016。E-mail:duanyang100@126.com   
作者简介: 林惠花 (1992-),女,福建宁德人,在读硕士研究生。E-mail:linhuihua112@yeah.net
引用本文:   
林惠花1,王瑞芳2,宁清灵1,徐志华1,杨本强3,张梦知1,蔡晓楠3,侯 洁1,段 阳3. 超急性期脑梗死大脑中动脉高密度征的综合分析[J]. 中国临床医学影像杂志, 2018, 29(9): 609-611.
LIN Hui-hua1, WANG Rui-fang2, NING Qing-ling1, XU Zhi-hua1, YANG Ben-qiang3,. Comprehensive analysis of the high density of middle cerebral artery sign in hyperacute cerebral infarction. JOURNAL OF CHINA MEDICAL IMAGING, 2018, 29(9): 609-611.
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