In order to effectively improve the pathological diagnosis capability and feature resolution of 3D human brain CT images,a threshold segmentation method of multi-resolution 3D human brain CT image based on edge pixel ...In order to effectively improve the pathological diagnosis capability and feature resolution of 3D human brain CT images,a threshold segmentation method of multi-resolution 3D human brain CT image based on edge pixel grayscale feature decomposition is proposed in this paper.In this method,first,original 3D human brain image information is collected,and CT image filtering is performed to the collected information through the gradient value decomposition method,and edge contour features of the 3D human brain CT image are extracted.Then,the threshold segmentation method is adopted to segment the regional pixel feature block of the 3D human brain CT image to segment the image into block vectors with high-resolution feature points,and the 3D human brain CT image is reconstructed with the salient feature point as center.Simulation results show that the method proposed in this paper can provide accuracy up to 100%when the signal-to-noise ratio is 0,and with the increase of signal-to-noise ratio,the accuracy provided by this method is stable at 100%.Comparison results show that the threshold segmentation method of multi-resolution 3D human brain CT image based on edge pixel grayscale feature decomposition is signicantly better than traditional methods in pathological feature estimation accuracy,and it effectively improves the rapid pathological diagnosis and positioning recognition abilities to CT images.展开更多
Eclampsia is a common complication of hypertensive disorders of pregnancy and in the puerperium with the attendant risk to both the mother and baby. Although it is a multi-systemic disorder, its manifestation that aff...Eclampsia is a common complication of hypertensive disorders of pregnancy and in the puerperium with the attendant risk to both the mother and baby. Although it is a multi-systemic disorder, its manifestation that affects the brain and resulting in altered sensorium demands brain imaging to define the possible brain lesions and the implications for critical care management and outcome. We evaluated the CT brain lesions in the patients with eclampsia who were admitted in the intensive care unit, University of Port Harcourt, Port Harcourt Nigeria. Objective: To analyse the CT brain images of eclamptic parturients and the outcome following their admission in the intensive care unit. Methods: We undertook this observational study after obtaining ethical exemption from the University of Portharcourt Teaching Hospital ethical review board, and commenced the review between March 2021 to February 2023. We included all parturients that were admitted into the intensive care unit of the University of Portharcourt Teaching Hospital, a nine-bedded open intensive care unit with the clinical diagnosis of eclampsia. Every admitted parturient was required to obtain a brain computed tomography (CT) by local protocol. The brain CT images were retrieved for review from the parturients’ relatives, radiology department and the ICU. Parturients included were aged ≥ 18 years. The radiological reports of these brain images which were also reviewed by a neurosurgeon in case of any need for secondary opinion were subjected to statistical analysis. Result: Thirty-one parturients were admitted with eclampsia with a mean age of 30 years ± 5.29. Sixteen (16) parturients died representing 52%. Only twenty-four (24) CT brain images were retrieved for review (77%). The following brain lesions were identified from the brain CT and they comprised the following: intracerebral haemorrhage, including extensions into the ventricles 7 (29.17%), cerebral oedema 12 (50%), subdural hematoma 1 (4.17%) and normal imaging 4 (16.66%). The subdural haematoma was promptly evacuated with a good outcome. Conclusion: Neuro imaging comprising computed tomography and magnetic resonance imaging of the brain are basic ancillary investigations for patients with eclampsia presenting with neurologic deficits and low GCS. Early presentation and access to brain CT could influence outcome as it was demonstrated in the prompt intervention in the patient with subdural haematoma which was evacuated with a satisfactory outcome.展开更多
Background CT is commonly used to image patients with ischaemic stroke but radiologist interpretation may be delayed.Machine learning techniques can provide rapid automated CT assessment but are usually developed from...Background CT is commonly used to image patients with ischaemic stroke but radiologist interpretation may be delayed.Machine learning techniques can provide rapid automated CT assessment but are usually developed from annotated images which necessarily limits the size and representation of development data sets.We aimed to develop a deep learning(DL)method using CT brain scans that were labelled but not annotated for the presence of ischaemic lesions.Methods We designed a convolutional neural network-based DL algorithm to detect ischaemic lesions on CT.Our algorithm was trained using routinely acquired CT brain scans collected for a large multicentre international trial.These scans had previously been labelled by experts for acute and chronic appearances.We explored the impact of ischaemic lesion features,background brain appearances and timing of CT(baseline or 24–48 hour follow-up)on DL performance.Results From 5772 CT scans of 2347 patients(median age 82),54%had visible ischaemic lesions according to experts.Our DL method achieved 72%accuracy in detecting ischaemic lesions.Detection was better for larger(80%accuracy)or multiple(87%accuracy for two,100%for three or more)lesions and with follow-up scans(76%accuracy vs 67%at baseline).Chronic brain conditions reduced accuracy,particularly non-stroke lesions and old stroke lesions(32%and 31%error rates,respectively).Conclusion DL methods can be designed for ischaemic lesion detection on CT using the vast quantities of routinely collected brain scans without the need for lesion annotation.Ultimately,this should lead to more robust and widely applicable methods.展开更多
This study was done to the review and documentation of brain CT investigations in King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia in 2012 including CT findings for brain based on justifications for sca...This study was done to the review and documentation of brain CT investigations in King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia in 2012 including CT findings for brain based on justifications for scan. The purpose of the study is to evaluate the situation of requesting CT brain versus the reporting findings. A retrospective study was carried out in the Department of Radiology, KAUH between 1 January and 31 December 2012. There were 417 children scanned by CT for brain, their data were reviewed and analyzed from radiology records to form the sample of the study. The study revealed that high percentages of radiological findings for CT brain did not confirm the clinical diagnosis. The percentages of such cases which observed in the three departments of emergency, inpatient and outpatient were 68.4%, 53.6% and 49.4% respectively. This result shows that a percentage of children were given unnecessary exposure to radiation among those who received CT brain from the radiology department in KAUH. From the study, it is concluded that most brain CT done for children were not justification as well as there were more brain CT findings not confirmed the clinical diagnosis, although the brain CT may be significant in most of the cases. Hence, there is a big concern about the increasing requests for unnecessary brain CT. Therefore, the paediatricians should be more careful in requesting of brain CT unless it is indispensible.展开更多
<strong>Background and Purpose</strong>: Increasing concern of cerebral venous thrombosis due to treatable and curable causes of stroke. The diagnosis of cerebral venous sinus thrombosis is challenged due ...<strong>Background and Purpose</strong>: Increasing concern of cerebral venous thrombosis due to treatable and curable causes of stroke. The diagnosis of cerebral venous sinus thrombosis is challenged due to nonspecific clinical symptomatology. Patients may present at an emergency room with a variety of neurological conditions such as severe headache, weakness, seizure, etc. Neuroimaging, particularly noncontrast cranial computed tomography (NCCT), is an investigation of choice in differentiation and triage the patients for further treatment. CT is sensitive in the detection of acute thrombosis or blood clots in all regions of the body. We hypothesize that NCCT might be sensitive to diagnose cerebral venous thrombosis immediately. <strong>Materials and Methods:</strong> Retrospectively review the electronic database of our patients, there are 27 patients with cerebral sinus venous thrombosis (SVT) and 4 patients with cerebral deep venous thrombosis (DVT). Other 79 patients present with clinically diagnosed cerebral venous thrombosis but the final result can exclude cerebral venous thrombosis. We use MR imaging and CT venography as the gold standard. Independently reviewed by two neuroradiologists for CT direct sign and CT indirect signs that suggest SVT or DVT. CT direct signs for SVT and DVT are the presence of hyperdensity in the sinus venous or deep venous system (cord sign, attenuated vein sign) and CT indirect signs are the changes in brain parenchyma (brain edema, hemorrhagic infarction). <strong>Results:</strong> Sensitivity and specificity of NCCT in detection attenuated vein sign and diagnosis DVT are 75% and 100% whereas the sensitivity and specificity of NCCT in detection cord sign and diagnosis SVT are 43.8% and 99.7% as respectively. <strong>Conclusions:</strong> NCCT might not sensitive in detection of SVT without CT direct sign which needs further investigation. However, NCCT might beneficial for emergency conditions such as DVT patients, cortical vein thrombosis and also in SVT patients with the positive CT direct sign.展开更多
目的:分析Brain Time Stack图像融合技术在CT中的应用。方法:选取2021年3月—2022年9月衡水市第四人民医院收治的50例CT检查患者作为研究对象。所有患者进行CT检查并进行Brain Time Stack后处理。比较四组不同部位CT值、标准差(SD)、信...目的:分析Brain Time Stack图像融合技术在CT中的应用。方法:选取2021年3月—2022年9月衡水市第四人民医院收治的50例CT检查患者作为研究对象。所有患者进行CT检查并进行Brain Time Stack后处理。比较四组不同部位CT值、标准差(SD)、信噪比(SNR)。比较四组图像主观质量评分。分析不同部位CT值、SD、SNR与图像主观质量评分的相关性。结果:B组的延髓、额叶灰质、额叶白质、小脑内侧、小脑外侧、颞肌肌肉CT值明显低于A组;C组的延髓、脑室、额叶白质、小脑内侧、小脑外侧、颞肌肌肉CT值高于A组;D组延髓、额叶灰质、颞肌肌肉CT值明显低于A组,脑室、额叶白质、小脑外侧CT值明显高于A组;C组延髓、额叶灰质、额叶白质、小脑内侧、小脑外侧、颞肌肌肉CT值明显高于B组;D组延髓、脑室、额叶白质、小脑内侧、小脑外侧、颞肌肌肉CT值明显高于B组;D组延髓、额叶灰质、额叶白质、小脑内侧、小脑外侧、颞肌肌肉CT值明显低于C组;D组脑室CT值明显高于C组,差异有统计学意义(P<0.05)。B组、C组、D组延髓、脑室、额叶灰质、额叶白质、小脑内侧、小脑外侧、颞肌肌肉SD值明显低于A组;C组延髓、脑室、额叶白质、小脑内侧、小脑外侧、颞肌肌肉SD值均明显高于B组;C组额叶灰质SD明显低于B组;D组延髓、脑室、额叶灰质、额叶白质、小脑内侧、小脑外侧、肌肉SD均明显低于B组、C组,差异有统计学意义(P<0.05)。B组、C组、D组延髓、脑室、额叶灰质、额叶白质、小脑内侧、小脑外侧、颞肌肌肉SNR均明显高于A组;C组、D组延髓、额叶灰质、额叶白质、小脑内侧、小脑外侧、颞肌肌肉SNR值明显高于B组;C组、D组脑室SNR明显低于B组;D组延髓、脑室、额叶灰质、额叶白质、小脑内侧、小脑外侧、颞肌肌肉SNR明显高于C组,差异有统计学意义(P<0.05)。D组图像主观质量评分最高,差异有统计学意义(P<0.05)。延髓、脑室、额叶灰质、额叶白质、小脑内侧、小脑外侧及颞肌肌肉SD与主观质量评分呈明显负相关,SNR与主观质量评分间呈明显正相关,差异有统计学意义(P<0.05)。结论:利用Brain Time Stack图像融合技术对头部CT扫描检查图像处理,动脉期结合前一期及后一期的图像数据在处理后具有更好的质量和更少的噪音。展开更多
目的:基于全脑CT灌注成像(CTP)参数构建急性缺血性脑卒中预后预测模型并验证其应用价值。方法:选取2021年1月至2024年7月于金华市人民医院接受治疗的急性脑卒中(AIS)患者200例作为研究对象,根据90 d改良Rankin量表(mRS)评分分为预后良好...目的:基于全脑CT灌注成像(CTP)参数构建急性缺血性脑卒中预后预测模型并验证其应用价值。方法:选取2021年1月至2024年7月于金华市人民医院接受治疗的急性脑卒中(AIS)患者200例作为研究对象,根据90 d改良Rankin量表(mRS)评分分为预后良好组(≤2分)和预后不良组(3~6分),比较两组患者的基本临床资料、全脑CTP参数差异;采用Spearman法分析CTP参数与90 d mRS评分的相关性;采用多因素Logistic回归模型分析AIS患者预后影响因素,绘制ROC曲线评估各因素预测AIS患者预后的价值;构建列线图预测模型并绘制ROC曲线验证其预测效果。结果:预后不良组的脑血流量(CBF)、相对脑血流量(r CBF)、缺血脑组织可恢复比率(PRR)显著低于预后良好组,而入院美国国立卫生研究院卒中量表(NIHSS)评分和梗死体积高于预后良好组,差异有统计学意义(P<0.05)。入院NIHSS评分、梗死体积均与90 d mRS评分呈正相关(r=0.665、0.707,P<0.01),而CBF、rCBF及PRR则与90 d mRS负相关(r=-0.476、-0.492、-0.307,P<0.01)。多因素Logistic分析结果显示,AIS患者预后的影响因素为入院NIHSS评分、CBF、梗死体积(P<0.05)。ROC曲线分析显示,CBF、梗死体积及入院NIHSS评分预测AIS预后的AUC分别为0.857(95%CI=0.778~0.936)、0.873(95%CI=0.796~0.951)和0.943(95%CI=0.880~1.000)。根据影响因素构建预测AIS患者预后不良的列线图模型。模型验证结果显示,C-index为0.88,AUC为0.989(95%CI=0.957~0.996),决策曲线显示模型具有良好的临床应用价值。结论:全脑CTP参数CBF、梗死体积及入院NIHSS评分为AIS患者预后不良影响因素,基于上述影响因素构建AIS患者预后不良预测模型经验证具有良好的预测价值,为临床医师提供了有益的参考工具。展开更多
Brain malformations are rare, difficult to diagnose and have unpredictable evolution. They are the major causes of epilepsy, psychomotor development abnormalities and other neurological disorders. The neuroimaging tec...Brain malformations are rare, difficult to diagnose and have unpredictable evolution. They are the major causes of epilepsy, psychomotor development abnormalities and other neurological disorders. The neuroimaging technique of choice for diagnosis of these malformations is magnetic resonance imaging (MRI), but unfortunately MRI is expensive, and is not available in a poor resource country like Cameroon. CT scan associated to clinical signs can help to suspect or to confirm a malformation. The authors report here three cases of malformations discovered during cranial CT scan at the regional hospital of Ngaoundéré. They are Dandy Walker malformation, Sturge Weber’s disease and hemimegalencephaly. These cases contribute to the knowledge of this rare event, and emphasize the importance of CT scan on their diagnosis in the absence of MRI.展开更多
文摘In order to effectively improve the pathological diagnosis capability and feature resolution of 3D human brain CT images,a threshold segmentation method of multi-resolution 3D human brain CT image based on edge pixel grayscale feature decomposition is proposed in this paper.In this method,first,original 3D human brain image information is collected,and CT image filtering is performed to the collected information through the gradient value decomposition method,and edge contour features of the 3D human brain CT image are extracted.Then,the threshold segmentation method is adopted to segment the regional pixel feature block of the 3D human brain CT image to segment the image into block vectors with high-resolution feature points,and the 3D human brain CT image is reconstructed with the salient feature point as center.Simulation results show that the method proposed in this paper can provide accuracy up to 100%when the signal-to-noise ratio is 0,and with the increase of signal-to-noise ratio,the accuracy provided by this method is stable at 100%.Comparison results show that the threshold segmentation method of multi-resolution 3D human brain CT image based on edge pixel grayscale feature decomposition is signicantly better than traditional methods in pathological feature estimation accuracy,and it effectively improves the rapid pathological diagnosis and positioning recognition abilities to CT images.
文摘Eclampsia is a common complication of hypertensive disorders of pregnancy and in the puerperium with the attendant risk to both the mother and baby. Although it is a multi-systemic disorder, its manifestation that affects the brain and resulting in altered sensorium demands brain imaging to define the possible brain lesions and the implications for critical care management and outcome. We evaluated the CT brain lesions in the patients with eclampsia who were admitted in the intensive care unit, University of Port Harcourt, Port Harcourt Nigeria. Objective: To analyse the CT brain images of eclamptic parturients and the outcome following their admission in the intensive care unit. Methods: We undertook this observational study after obtaining ethical exemption from the University of Portharcourt Teaching Hospital ethical review board, and commenced the review between March 2021 to February 2023. We included all parturients that were admitted into the intensive care unit of the University of Portharcourt Teaching Hospital, a nine-bedded open intensive care unit with the clinical diagnosis of eclampsia. Every admitted parturient was required to obtain a brain computed tomography (CT) by local protocol. The brain CT images were retrieved for review from the parturients’ relatives, radiology department and the ICU. Parturients included were aged ≥ 18 years. The radiological reports of these brain images which were also reviewed by a neurosurgeon in case of any need for secondary opinion were subjected to statistical analysis. Result: Thirty-one parturients were admitted with eclampsia with a mean age of 30 years ± 5.29. Sixteen (16) parturients died representing 52%. Only twenty-four (24) CT brain images were retrieved for review (77%). The following brain lesions were identified from the brain CT and they comprised the following: intracerebral haemorrhage, including extensions into the ventricles 7 (29.17%), cerebral oedema 12 (50%), subdural hematoma 1 (4.17%) and normal imaging 4 (16.66%). The subdural haematoma was promptly evacuated with a good outcome. Conclusion: Neuro imaging comprising computed tomography and magnetic resonance imaging of the brain are basic ancillary investigations for patients with eclampsia presenting with neurologic deficits and low GCS. Early presentation and access to brain CT could influence outcome as it was demonstrated in the prompt intervention in the patient with subdural haematoma which was evacuated with a satisfactory outcome.
基金Health Data Research UK(Grant ID:EDIN1)The Royal College of Radiologists’2018 Pump Priming Grant and the UK Dementia Research Institute+2 种基金IST-3 was funded chiefly by the UK Medical Research Council(MRC G0400069,EME 09-800-15)the UK Stroke Association.GM is a Stroke Association Edith Murphy Foundation Senior Clinical Lecturer(SA L-SMP 18\1000)UK Research and Innovation(grant EP/S02431X/1)UKRI Centre for Doctoral Training in Biomedical AI at the University of Edinburgh,School of Informatics.
文摘Background CT is commonly used to image patients with ischaemic stroke but radiologist interpretation may be delayed.Machine learning techniques can provide rapid automated CT assessment but are usually developed from annotated images which necessarily limits the size and representation of development data sets.We aimed to develop a deep learning(DL)method using CT brain scans that were labelled but not annotated for the presence of ischaemic lesions.Methods We designed a convolutional neural network-based DL algorithm to detect ischaemic lesions on CT.Our algorithm was trained using routinely acquired CT brain scans collected for a large multicentre international trial.These scans had previously been labelled by experts for acute and chronic appearances.We explored the impact of ischaemic lesion features,background brain appearances and timing of CT(baseline or 24–48 hour follow-up)on DL performance.Results From 5772 CT scans of 2347 patients(median age 82),54%had visible ischaemic lesions according to experts.Our DL method achieved 72%accuracy in detecting ischaemic lesions.Detection was better for larger(80%accuracy)or multiple(87%accuracy for two,100%for three or more)lesions and with follow-up scans(76%accuracy vs 67%at baseline).Chronic brain conditions reduced accuracy,particularly non-stroke lesions and old stroke lesions(32%and 31%error rates,respectively).Conclusion DL methods can be designed for ischaemic lesion detection on CT using the vast quantities of routinely collected brain scans without the need for lesion annotation.Ultimately,this should lead to more robust and widely applicable methods.
文摘This study was done to the review and documentation of brain CT investigations in King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia in 2012 including CT findings for brain based on justifications for scan. The purpose of the study is to evaluate the situation of requesting CT brain versus the reporting findings. A retrospective study was carried out in the Department of Radiology, KAUH between 1 January and 31 December 2012. There were 417 children scanned by CT for brain, their data were reviewed and analyzed from radiology records to form the sample of the study. The study revealed that high percentages of radiological findings for CT brain did not confirm the clinical diagnosis. The percentages of such cases which observed in the three departments of emergency, inpatient and outpatient were 68.4%, 53.6% and 49.4% respectively. This result shows that a percentage of children were given unnecessary exposure to radiation among those who received CT brain from the radiology department in KAUH. From the study, it is concluded that most brain CT done for children were not justification as well as there were more brain CT findings not confirmed the clinical diagnosis, although the brain CT may be significant in most of the cases. Hence, there is a big concern about the increasing requests for unnecessary brain CT. Therefore, the paediatricians should be more careful in requesting of brain CT unless it is indispensible.
文摘<strong>Background and Purpose</strong>: Increasing concern of cerebral venous thrombosis due to treatable and curable causes of stroke. The diagnosis of cerebral venous sinus thrombosis is challenged due to nonspecific clinical symptomatology. Patients may present at an emergency room with a variety of neurological conditions such as severe headache, weakness, seizure, etc. Neuroimaging, particularly noncontrast cranial computed tomography (NCCT), is an investigation of choice in differentiation and triage the patients for further treatment. CT is sensitive in the detection of acute thrombosis or blood clots in all regions of the body. We hypothesize that NCCT might be sensitive to diagnose cerebral venous thrombosis immediately. <strong>Materials and Methods:</strong> Retrospectively review the electronic database of our patients, there are 27 patients with cerebral sinus venous thrombosis (SVT) and 4 patients with cerebral deep venous thrombosis (DVT). Other 79 patients present with clinically diagnosed cerebral venous thrombosis but the final result can exclude cerebral venous thrombosis. We use MR imaging and CT venography as the gold standard. Independently reviewed by two neuroradiologists for CT direct sign and CT indirect signs that suggest SVT or DVT. CT direct signs for SVT and DVT are the presence of hyperdensity in the sinus venous or deep venous system (cord sign, attenuated vein sign) and CT indirect signs are the changes in brain parenchyma (brain edema, hemorrhagic infarction). <strong>Results:</strong> Sensitivity and specificity of NCCT in detection attenuated vein sign and diagnosis DVT are 75% and 100% whereas the sensitivity and specificity of NCCT in detection cord sign and diagnosis SVT are 43.8% and 99.7% as respectively. <strong>Conclusions:</strong> NCCT might not sensitive in detection of SVT without CT direct sign which needs further investigation. However, NCCT might beneficial for emergency conditions such as DVT patients, cortical vein thrombosis and also in SVT patients with the positive CT direct sign.
文摘目的:分析Brain Time Stack图像融合技术在CT中的应用。方法:选取2021年3月—2022年9月衡水市第四人民医院收治的50例CT检查患者作为研究对象。所有患者进行CT检查并进行Brain Time Stack后处理。比较四组不同部位CT值、标准差(SD)、信噪比(SNR)。比较四组图像主观质量评分。分析不同部位CT值、SD、SNR与图像主观质量评分的相关性。结果:B组的延髓、额叶灰质、额叶白质、小脑内侧、小脑外侧、颞肌肌肉CT值明显低于A组;C组的延髓、脑室、额叶白质、小脑内侧、小脑外侧、颞肌肌肉CT值高于A组;D组延髓、额叶灰质、颞肌肌肉CT值明显低于A组,脑室、额叶白质、小脑外侧CT值明显高于A组;C组延髓、额叶灰质、额叶白质、小脑内侧、小脑外侧、颞肌肌肉CT值明显高于B组;D组延髓、脑室、额叶白质、小脑内侧、小脑外侧、颞肌肌肉CT值明显高于B组;D组延髓、额叶灰质、额叶白质、小脑内侧、小脑外侧、颞肌肌肉CT值明显低于C组;D组脑室CT值明显高于C组,差异有统计学意义(P<0.05)。B组、C组、D组延髓、脑室、额叶灰质、额叶白质、小脑内侧、小脑外侧、颞肌肌肉SD值明显低于A组;C组延髓、脑室、额叶白质、小脑内侧、小脑外侧、颞肌肌肉SD值均明显高于B组;C组额叶灰质SD明显低于B组;D组延髓、脑室、额叶灰质、额叶白质、小脑内侧、小脑外侧、肌肉SD均明显低于B组、C组,差异有统计学意义(P<0.05)。B组、C组、D组延髓、脑室、额叶灰质、额叶白质、小脑内侧、小脑外侧、颞肌肌肉SNR均明显高于A组;C组、D组延髓、额叶灰质、额叶白质、小脑内侧、小脑外侧、颞肌肌肉SNR值明显高于B组;C组、D组脑室SNR明显低于B组;D组延髓、脑室、额叶灰质、额叶白质、小脑内侧、小脑外侧、颞肌肌肉SNR明显高于C组,差异有统计学意义(P<0.05)。D组图像主观质量评分最高,差异有统计学意义(P<0.05)。延髓、脑室、额叶灰质、额叶白质、小脑内侧、小脑外侧及颞肌肌肉SD与主观质量评分呈明显负相关,SNR与主观质量评分间呈明显正相关,差异有统计学意义(P<0.05)。结论:利用Brain Time Stack图像融合技术对头部CT扫描检查图像处理,动脉期结合前一期及后一期的图像数据在处理后具有更好的质量和更少的噪音。
文摘目的:基于全脑CT灌注成像(CTP)参数构建急性缺血性脑卒中预后预测模型并验证其应用价值。方法:选取2021年1月至2024年7月于金华市人民医院接受治疗的急性脑卒中(AIS)患者200例作为研究对象,根据90 d改良Rankin量表(mRS)评分分为预后良好组(≤2分)和预后不良组(3~6分),比较两组患者的基本临床资料、全脑CTP参数差异;采用Spearman法分析CTP参数与90 d mRS评分的相关性;采用多因素Logistic回归模型分析AIS患者预后影响因素,绘制ROC曲线评估各因素预测AIS患者预后的价值;构建列线图预测模型并绘制ROC曲线验证其预测效果。结果:预后不良组的脑血流量(CBF)、相对脑血流量(r CBF)、缺血脑组织可恢复比率(PRR)显著低于预后良好组,而入院美国国立卫生研究院卒中量表(NIHSS)评分和梗死体积高于预后良好组,差异有统计学意义(P<0.05)。入院NIHSS评分、梗死体积均与90 d mRS评分呈正相关(r=0.665、0.707,P<0.01),而CBF、rCBF及PRR则与90 d mRS负相关(r=-0.476、-0.492、-0.307,P<0.01)。多因素Logistic分析结果显示,AIS患者预后的影响因素为入院NIHSS评分、CBF、梗死体积(P<0.05)。ROC曲线分析显示,CBF、梗死体积及入院NIHSS评分预测AIS预后的AUC分别为0.857(95%CI=0.778~0.936)、0.873(95%CI=0.796~0.951)和0.943(95%CI=0.880~1.000)。根据影响因素构建预测AIS患者预后不良的列线图模型。模型验证结果显示,C-index为0.88,AUC为0.989(95%CI=0.957~0.996),决策曲线显示模型具有良好的临床应用价值。结论:全脑CTP参数CBF、梗死体积及入院NIHSS评分为AIS患者预后不良影响因素,基于上述影响因素构建AIS患者预后不良预测模型经验证具有良好的预测价值,为临床医师提供了有益的参考工具。
文摘Brain malformations are rare, difficult to diagnose and have unpredictable evolution. They are the major causes of epilepsy, psychomotor development abnormalities and other neurological disorders. The neuroimaging technique of choice for diagnosis of these malformations is magnetic resonance imaging (MRI), but unfortunately MRI is expensive, and is not available in a poor resource country like Cameroon. CT scan associated to clinical signs can help to suspect or to confirm a malformation. The authors report here three cases of malformations discovered during cranial CT scan at the regional hospital of Ngaoundéré. They are Dandy Walker malformation, Sturge Weber’s disease and hemimegalencephaly. These cases contribute to the knowledge of this rare event, and emphasize the importance of CT scan on their diagnosis in the absence of MRI.
