摘要
目的分析颈动脉斑块高分辨率磁共振成像(MRI)联合炎性因子水平检测对缺血性脑卒中的评估价值。方法选取2024年1月至2024年12月我院收治的疑似缺血性脑卒中患者98例,均行颈动脉斑块高分辨率MRI检查和炎性因子[超敏C-反应蛋白(hs-CRP)、脑钠肽(BNP)]水平检测。以脑血管造影术检查结果作为“金标准”,分析高分辨率MRI、炎性因子水平对缺血性脑卒中的诊断效能。比较不同分型(颈动脉斑块合并脑卒中、颈动脉斑块及无颈动脉斑块脑卒中)患者的MRI影像学参数(MTT、TTP、CBF、CBV)以及hs-CRP、BNP水平,绘制受试者工作特征(ROC)曲线分析颈动脉斑块高分辨率MRI联合炎性因子预测缺血性脑卒中的价值。结果脑血管造影术共检出缺血性脑卒中阳性59例、阴性39例;高分辨率MRI联合hs-CRP、BNP检出缺血性脑卒中阳性60例(含真阳性58例)、阴性38例(含真阴性37例),其准确度(96.94%)、灵敏度(98.31%)均较单一指标高(P<0.05)。颈动脉斑块合并脑卒中患者的MTT、TTP、hs-CRP、BNP水平均高于无颈动脉斑块脑卒中、颈动脉斑块患者,CBF、CBV均低于无颈动脉斑块脑卒中、颈动脉斑块患者(P<0.05);无颈动脉斑块脑卒中患者与颈动脉斑块患者的MRI影像学参数、炎性因子水平比较,差异无统计学意义(P>0.05)。ROC曲线预测模型的最佳临界值为0.89,高分辨率MRI联合炎性因子水平的灵敏度、特异度均显著高于单一指标,其AUC为0.931,预测价值最高。结论颈动脉斑块高分辨率MRI联合炎性因子水平检测对缺血性脑卒中有较高的评估价值,可更为灵敏、准确地诊断出疾病分型情况,从而为后续治疗提供有益参考。
Objective To analyze the evaluation value of carotid plaque high-resolution magnetic resonance imaging(MRI)combined with detection of inflammatory factor levels for ischemic stroke.Methods A total of 98 patients with suspected ischemic stroke admitted to our hospital from January 2024 to December 2024 were selected for high-resolution MRI examination of carotid plaques and detection of inflammatory factors[high-sensitivity C-reactive protein(hs-CRP)and brain natriuretic peptide(BNP)]levels.Using the results of cerebral angiography as the"gold standard",the diagnostic efficacy of high-resolution MRI and inflammatory factor levels for ischemic stroke was analyzed.The MRI imaging parameters(MTT,TTP,CBF,CBV)and the levels of hs-CRP and BNP of patients with different subtypes(carotid plaque combined with stroke,carotid plaque,and stroke without carotid plaque)were compared,and the receiver operating characteristic(ROC)curve was plotted to analyze the value of high-resolution MRI of carotid plaques combined with inflammatory factors in predicting ischemic stroke.Results Cerebral angiography detected 59 positive cases and 39 negative cases of ischemic stroke;High-resolution MRI combined with hs-CRP and BNP identified 60 positive cases(including 58 true positives)and 38 negative cases(including 37 true negatives),demonstrating higher accuracy(96.94%)and sensitivity(98.31%)compared to individual indicators(P<0.05).In patients with carotid plaque combined with stroke,MTT,TTP,hs-CRP,and BNP levels were significantly higher,while CBF and CBV were significantly lower than those in stroke patients without carotid plaque or patients with carotid plaque alone(P<0.05);No statistically significant differences were found in MRI parameters or inflammatory factor levels between stroke patients without carotid plaque and patients with carotid plaque alone(P>0.05).The ROC curve predictive model yielded an optimal cut-off value of 0.89;The sensitivity and specificity of high-resolution MRI combined with inflammatory factor levels were significantly higher than those of single indicator,with the A UC of 0.931,indicating the highest predictive value.Conclusions Carotid plaque high-resolution MRI combined with detection of inflammatory factor levels has high evaluation value for ischemic stroke,and can more sensitively and accurately diagnose disease classification,so as to provide useful reference for subsequent treatment.
作者
贾茂林
梁启龙
魏进旺
何家骥
杨君
贾创创
张弘
杨海承
金鑫
王慧
JIA Maolin;LIANG Qilong;WEI Jinwang;HE Jiaji;YANG Jun;JIA Chuanchuang;ZHANG Hong;YANG Haicheng;JIN Xin;WANG Hui(Department of Neurosurgery,the No.2 People's Hospital of Lanzhou,Lanzhou 730046,China)
出处
《临床医学工程》
2025年第5期527-531,共5页
Clinical Medicine & Engineering
基金
兰州市卫生健康科技发展项目(项目编号:2021019
2021032)。
关键词
颈动脉斑块
高分辨率磁共振成像
炎性因子
超敏C-反应蛋白
脑钠肽
缺血性脑卒中
Carotid plaque
High-resolution magnetic resonance imaging
Inflammatory factor
High-sensitivity C-reactive protein
Brain natriuretic peptide
Ischemic stroke
