The evaluation value of dual low-dose CTP-CTA in the degree of brain injury in patients with anterior circulation LVO-AIS

ZHOU Ruichen; WANG Long; ZHANG Jianfeng; LI Jing; ZHOU Rui

doi:10.20258/j.cnki.1006-9011.2025.06.003

Abstract：Objective To investigate the value of double low-dose CT perfusion imaging(CTP)and CT angiography(CTA)in evaluating the degree of brain injury in patients with anterior great vascular occlusive acute ischemic stroke(LVO-AIS).Methods 116 patients with anterior circulation LVO-AIS were selected and divided into mild group(NIHSS score 0-4,43 cases),moderate group(NIHSS score 5-20,52 cases)and severe group(NIHSS score>20,21 cases)according to NIHSS scale.All subjects received low-dose CTP and CTA examination on the day of admission.The contrast between the lesion area and normal tissue was distinguished and highlighted by false color processing,and the lesion was divided into the central area of the lesion(central area of the lesion),the surrounding area of the lesion(peripheral area of the lesion),the area between the center and surrounding area of the lesion(average area of the lesion),and the normal area corresponding to the lesion area(con-tralateral corresponding area).The parameters of CTP-CTA scan in three groups were compared,including cerebral blood flow(CBF),peak start time(TS),peak arrival time(TTP),cerebral blood volume(CBV),and Maas score.Spearman correlation coefficient was used to analyze the relationship between the scanning parameters of double low-dose CTP-CTA and the degree of brain injury in anterior circulation LVO-AIS patients.The parameters of double low-dose CTP-CTA scanning were compared be-tween the central and peri-focal areas,and between the mean and contralateral areas.Receiver operating characteristic(ROC)curves were drawn to evaluate the value of double low-dose CTP-CTA in the assessment of moderate to severe brain injury in pa-tients with anterior circulation LVO-AIS.Results CBF,CBV in mild group were higher than those in moderate group and se-vere group,and moderate group was higher than severe group(P<0.05).TS and TTP in mild group were lower than those in mod-erate group and severe group,and moderate group was lower than severe group(P<0.05).The proportion of Maas score≤2 in mild group was lower than that in moderate group and severe group,and the moderate group was lower than that in severe group(P<0.05).The scanning parameters,CBF,CBV of double low-dose CTP-CTA,were negatively correlated with the degree of brain injury in patients with anterior circulation LVO-AIS(r was-0.587,-0.582,respectively,P<0.05).The scores of TS,TTP and Maas were positively correlated with the degree of brain injury in anterior circulation LVO-AIS patients(r was 0.614,0.610 and 0.603,respectively,P<0.05).CBF,CBV in the central area were lower than those around the lesion,while,TS and TTP were higher than those around the lesion(all P<0.05).The average lesion area of CBF,CBV was lower than that of the contralat-eral corresponding area,and the average lesion area of TS and TTP was higher than that of the contralateral corresponding area(P<0.05).The AUC of moderate-severe brain injury in patients with precirculating LVO-AIS assessed by dual low-dose CTP-CTA scanning parameters combined was higher than that of patients with moderate-severe brain injury assessed by dual low-dose CTP-CTA scanning parameters alone(Z was 2.152,2.397,2.186,2.513,2.221,2.739,all P<0.05).Conclusion Double low-dose CTP-CTA scan parameters can distinguish focal areas,which has high value in evaluating moderate and severe brain in-jury in patients with anterior circulation LVO-AIS.