摘要
目的研究应用磁共振弥散张量成像(Difusion Tensor Imaging,DTI)评估高血压性脑出血(Hypertensive Intracerebral Hemorrhage,HICH)预后不良风险的有效性。方法研究对象选取为2018年5月-2023年12月于本院就诊的HICH患者152例。基于患者发病起3个月后的受累肢体力量恢复情况,将患者划分为预后良好组、预后不良好组。比较预后良好组、预后不良组一般资料、DTI参数(FA、MD、RD、AD)、NIHSS及PG评分;分析影响HICH患者预后不良的多因素;Pearson相关系数分析DTI参数变化与NIHSS及PG评分间的相关性。通过ROC曲线分析,发现DTI参数的最佳截断值,计算截断值预测HICH患者预后的敏感性和特异性。结果152例HICH患者中预后良好组107例、预后不良组45例。两组性别、年龄、高血压严重程度、高血压病程及合并症比较,差异无统计学意义(P>0.05);预后不良组FA、AD值低于预后良好组,MD、RD、NIHSS及PG评分高于预后良好组(P<0.05)。二元Logistic回归模型显示:FA、AD下降,MD、RD、NIHSS及PG评分是影响HICH患者预后不良的多因素(P<0.05)。经Pearson相关性显示:FA、AD均与NIHSS及PG评分呈负相关,MD、RD与NIHSS及PG评分呈正相关(P<0.05)。FA、MD、RD及AD联合评估HICH患者预后风险的AUC(95%CI)、敏感度及特异度分别为0.906(0.844-0.956)、88.62%及84.33%,显著高于FA、MD、RD及AD单一评估的预测效果(P<0.05)。结论应用DTI技术评估HICH患者的预后不良风险具有一定预测价值,且FA、MD、RD及AD联合评估在可显著提高其预测准确性。
Objective To study the effectiveness of DTI in evaluating the risk of poor prognosis in patients with HICH.Methods The subjects of this study were 152 HICH patients who were treated in our hospital from May 2018 to December 2023.Based on the recovery of affected limb strength 3 months after the onset of the disease,the patients were divided into good prognosis group and poor prognosis group.The general data,DTI parameters(FA,MD,RD,AD),NIHSS and PG scores of the good prognosis group and the poor prognosis group were compared.The multiple factors affecting the poor prognosis of HICH patients were analyzed.Pearson correlation coefficient was used to analyze the correlation between DTI parameters and NIHSS and PG scores.Through ROC curve analysis,the optimal cut-off value of DTI parameters was determined,and the sensitivity and specificity of the cut-off value in predicting the prognosis of HICH patients were evaluated.Results Of the 152 HICH patients,107 were in the good prognosis group and 45 in the poor prognosis group.There was no significant difference in gender,age,severity of hypertension,duration of hypertension and complications between the two groups(P>0.05).The FA and AD in the poor prognosis group were lower than those in the good prognosis group,and the MD,RD,NIHSS and PG scores were higher than those in the good prognosis group(P<0.05).Binary logistic regression model showed that FA and AD decreased,MD,RD,NIHSS and PG scores were multiple factors affecting the poor prognosis of HICH patients(P<0.05).According to Pearson correlation,FA and AD were negatively correlated with NIHSS and PG scores,and MD and RD were positively correlated with NIHSS and PG scores(P<0.05).The AUC(95%CI),sensitivity and specificity of FA,MD,RD and AD in evaluating the prognostic risk of HICH patients were 0.906(0.844-0.956),88.62%and 84.33%,respectively,which were significantly higher than those of FA,MD,RD and AD alone(P<0.05).Conclusion The application of DTI technology to evaluate the risk of poor prognosis in patients with HICH has certain predictive value,and the combined evaluation of FA,MD,RD and AD can significantly improve its predictive accuracy.
作者
陈贵杰
杨安强
陈有林
刘俊才
蔡中海
CHEN Gui-jie;YANG An-qiang;CHEN You-lin;LIU Jun-cai;CAI Zhong-hai(Department of NeurosurgeryⅡ,The First People's Hospital of Yibin,Yibin 644000,Sichuan Province,China)
出处
《中国CT和MRI杂志》
2025年第7期35-38,共4页
Chinese Journal of CT and MRI
基金
四川省区域创新合作项目(2024YFHZ0067)。
关键词
磁共振
弥散张量成像
高血压性脑出血
预后不良
Magnetic Resonance
Diffusion Tensor Imaging
Hypertensive Cerebral Hemorrhage
Poor Prognosis
