CTPI灌注成像结果与TLR4的表达量在急性脑梗死早期诊断的价值分析.DOCVIP

容积CT灌注成像与Toll样受体4检测在急性脑梗死早期诊断中的应用 唐骏,李罗清*（湖南省岳阳市一人民医院神经内科，湖南岳阳414000）[摘要] 目的 研究CTPI灌注成像结果与血清TLR4的表达量在急性脑梗死早期诊断的价值,为临床诊治提供参考。方法 选择我院神经内科2013年6月～2014年12月住院并诊断为急性脑梗死患者81例为观察对象，以MRI诊断为金标准，先后对患者行普通CT扫描及CTPI诊断。对比两种检测方式的诊断灵敏度，比较不同病重程度患者血清TLR4、TNF-α的表达差异。结果? CTPI组的灵敏度、准确度（91.14%、91.36%）明显高于普通CT扫描组（77.22%、77.78%）（P均＜0.05），CTPI组的漏诊率明显低于普通CT扫描组（8.86% vs 22.78%），差异具有统计学意义（P＜0.05）；72例患者CTPI诊断异常，病灶BV、BF值均明显小于健侧脑实质，MTT值明显高于健侧脑实质；中重型脑梗死患者血清TLR4的表达量及TNF-α值均显著大于轻型脑梗死（P＜0.05）。结论? CTPI灌注成像诊断急性脑梗死的效果显著优于普通CT扫描，中重型脑梗死患者TLR4表达量较高，对临床诊断具有参考价值。[关键词] CT灌注成像；CT扫描；TLR4；TNF-αApplication of volume CT perfusion imaging and Toll like receptor 4 detection in early diagnosis of acute cerebral infarction? ?TANG-Jun,,LILuo-Qing(TheYueyang City, Hunan [Abstract]? Objective? To explore the clinical value of the volume CT perfusion imaging and the serum levels of Toll like receptor 4 (TLR-4) in early diagnosis of acute cerebral infarction (ACI), in order to provide the clinical reference to ACI. Methods 81 patients diagnosed to ACI in our hospital from June 2013 to December 2014 were selected to the observation object. The MRI detection was regard to the gold standard. All patients with ACI were received the ordinary CT scan and CTPI. The results of two diagnostic methods were compared and the serum levels of TLR4 and TNF-α were compared among the different severities of patients with ACI. Results The sensitivity and accuracy of CTPI were significantly higher than the plain CT scan, which were 91.14% vs 77.22% (P=0.007) and 91.36% vs 77.78% (P=0.008).And the misdiagnosis rate of CTPI were significantly lower than the plain CT scan, which were 8.86% vs 22.78% (P=0.007). Among the 72 patients diagnosed to ACI by CTPI, the values of BV and BF of abnormal brain parenchyma were smaller than the contralateral brain parenchyma (both P0.05), and the values of MTT of abnormal brain parenchyma were higher than the contralateral brain parenchyma (P0.05). The serum levels of TLR4 and TN