The Predictive Value of Low Perfusion Intensity Ratio in CT Perfusion Imaging for the Prognosis of Acute Cerebral Infarction

ZHOU Zhenshou; YE Chengbin; HE Yanyan; DU Haolan; PAN Jiena

doi:10.13919/j.issn.2095-6274.ZHJY202409011

Abstract：Objective This study aims to evaluate the prognostic value of the hypoperfusion intensity ratio(HIR)derived from CT perfusion imaging in predicting outcomes in patients with acute cerebral infarction.Methods A total of 80 patients with acute cerebral infarction,treated in the Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine from May 2023 to April 2024,were included in this study.Based on the modified Rankin Scale(mRS)scores at the 90-day follow-up,patients were categorized into two groups:the poor prognosis group(26 patients with mRS scores of 3-5)and the good prognosis group(54 patients with mRS scores of 0-2).Differences between groups were compared,and factors influencing prognosis,as well as independent predictors,were analyzed.Results The good prog-nosis group had lower admission NIHSS scores,less extensive collateral circulation(CC),lower HIR,and shorter relative Tmax in the hypoperfused area compared to the poor prognosis group(P＜0.05).The relative cerebral blood flow(rCBF)and relative cerebral blood volume(rCBV)in the hypoperfused area were higher in the good prognosis group(P＜0.05).Poor CC and higher HIR were identified as independent predictors of poor prognosis.Both poor CC and higher HIR were positively correlated with 90-day mRS scores.The areas under the curve(AUC)for predicting patient outcomes using HIR,rCBF,rCBV,and relative Tmax in the hypoperfused area were 0.982(0.925-0.997),0.848(0.750-0.945),0.851(0.756-0.946),and 0.870(0.780-0.960),respectively.The optimal cutoff values were 0.41,0.56(ml·100 g-1·min-1),0.66(ml·100 g1),and 1.36 s,with high sensitivity and specificity for prognosis prediction.Conclusion Poor collateral cir-culation and higher HIR are independent risk factors for poor prognosis in acute cerebral infarction.CT perfusion imaging using HIR provides significant predictive value for patient outcomes.