Clinical significance of CT perfusion imaging combined with artificial intelligence in evaluating reperfusion injury after cerebral infarction

LU Wei; ZHANG Pan; QIN Yushu

doi:10.3969/j.issn.1006-5725.2025.02.017

Abstract：Objective To analyze the significance of CT perfusion imaging combined with artificial intelli-gence (AI) in evaluating reperfusion injury after cerebral infarction. Methods 106 patients with cerebral infarc-tion admitted to the hospital from January 2019 to October 2023 were prospectively selected as the study objects. Patients were divided into reperfusion injury group and no perfusion injury group according to whether reperfusion injury occurred after 14 days of thrombolytic therapy. CT perfusion imaging and AI parameters were compared between reperfusion injury group and non-perfusion injury group. The factors affecting reperfusion injury in cerebral infarction patients after thrombolytic therapy were analyzed. The value of CT perfusion imaging parameters combined with AI in predicting reperfusion injury after thrombolytic therapy in cerebral infarction patients was analyzed. Results 31 cases had reperfusion injury,and the other 75 cases had no perfusion injury. CBF,average CT value and entropy level in the reperfusion injury group were lower than those in the non-perfusion injury group (P<0.05),CBV,MTT,TTP and kurtosis were higher than those in the non-perfusion injury group (P<0.05). Logistic regression analysis showed that NIHSS (OR=5.228,95％CI:2.151～12.705),CBF(OR=3.777,95％CI:1.554～9.180),CBV(OR=3.699,95％CI:1.522～9.989) and average CT value (OR=4.125,95％CI:1.697～10.024) were the influencing factors of reperfusion injury in cerebral infarction patients after thrombolytic therapy (P<0.05). ROC curve results showed that the sensitivity of CBF,CBV,average CT value and their com-bination in predicting reperfusion injury after thrombolytic therapy in cerebral infarction patients were 67.74％,70.97％,77.42％,87.10％,and the specificity were 70.67％,74.67％,77.33％,90.67％,AUC values were 0.665,0.667,0.744 and 0.908. Conclusion CT perfusion imaging combined with AI is effective in evaluating reperfusion injury after cerebral infarction.