Predictive value of low-dose dual-source CT cerebral perfusion imaging for vascular dementia after thrombolysis in ce-rebral infarction

SUN Peng; HUANG Zhijun; WANG Lifeng; ZHANG Jiaoyang

doi:10.20258/j.cnki.1006-9011.2025.10.007

Abstract：Objective To investigate the predictive value of low-dose dual-source cerebral CT perfusion imaging(CTP)in vascular dementia(VD)after thrombolysis in cerebral infarction.Methods A total of 170 patients with cerebral infarction were selected for low dose dual-source CTP examination after thrombolytic surgery.Cerebral blood flow(CBF),cerebral blood volume(CBV)and peak time(MTT)were measured.According to whether VD occurred 6 months after thrombolytic therapy,41 cases were divided into VD group and 129 cases were not VD group.The clinical data and CTP parameters of the two groups were compared.Logistic regression model was used to analyze the influencing factors of VD after thrombolysis in cerebral infarc-tion.Pearson correlation coefficient was used to analyze the correlation between CTP parameters and Montreal Cognitive Assess-ment Scale(MoCA)scores.ROC curve was used to analyze the predictive efficacy of CTP parameters on VD after thrombolysis in cerebral infarction.Results The CBF and CBV of VD group were lower than those of non-VD group,and the MTT of VD group was higher than that of non-VD group(P<0.05).The age,history of stroke and number of lesions in VD group were higher than those in non-VD group(P<0.05).History of stroke,multiple lesions and high MTT were risk factors for VD after thrombolysis,while,high CBF and high CBV were protective risk factors(P<0.05).CBF,CBV and MoCA scores were positively correlated(r was 0.561 and 0.483,respectively,P<0.05),while MTT and MoCA scores were negatively correlated(r=-0.502,P<0.05).ROC analysis results showed that the AUC of CBF,CBV and MTT alone and combined to predict VD after thrombolysis in cere-bral infarction were 0.749(0.677-0.813),0.689(0.614-0.758),0.696(0.6621-0.764)and 0.886(0.828-0.930),respectively.The combined prediction efficiency of the three tests was higher than that of each single test(Z=2.864,2.991,3.417,P<0.05).Conclusion The levels of CBF and CBV decreased abnormally and the levels of MTT increased abnormally in VD patients with cerebral infarction after thrombolysis,which were closely related to MoCA score.CBF,CBV and MTT had high predictive value for the occurrence of VD after thrombolysis in cerebral infarction.