【摘要】 目的 探讨基于能谱CT介入后脑高密度灶（PCHD）的碘浓度及碘分布范围量化参数对急性缺血性脑卒中（AIS）患者血管内治疗（EVT）后出血转化（HT）的预测价值。方法 选取2022年1月至2025年1月期间佛山市三水区人民医院收治的接受EVT术后能谱CT检查判断PCHD的AIS患者91例为研究对象，根据患者术后是否发生HT将其分为HT组（n=31）和非HT组（n=60）。采用能谱CT测量PCHD的最大碘浓度及PCHD-阿尔伯塔卒中项目早期CT(ASPECT)评分评价与HT的相关性。结果 与非HT组相比较，HT组PCHD-ASPECT评分更低、最大碘浓度更高（均P<0.05）。多因素Logistic回归分析结果显示，PCHD-ASPECT评分降低、最大碘浓度升高是AIS患者EVT后HT的危险因素（P<0.05）。PCHD碘浓度与PCHD-ASPECT评分曲线下面积分别为0.909和0.899。结论 基于能谱CT的PCHD-ASPECT评分、PCHD碘浓度在预测AIS患者EVT后HT方面具有较高的价值。更多还原

【Abstract】 Objective To investigate the predictive value of quantitative parameters of iodine concentration and distribution range of postinterventional cerebral hyperdensities(PCHD) based on spectral CT for hemorrhagic transformation(HT) after endovascular treatment(EVT) in patients with acute ischemic stroke(AIS).Methods Ninety-one patients who received EVT and spectral CT examination to judge PCHD in Foshan Sanshui District People’s Hospital from January 2022 to January 2025 were selected as the research objects. They were assigned to HT group(n=31) or non-HT group(n=60). The maximum iodine concentration of PCHD and the PCHD-ASPECT score were evaluated by spectral CT. The correlation between the two parameters and HT was investigated.Results Compared with the non-HT group, HT group had lower PCHD-ASPECT score and higher maximum iodine concentration(both P<0. 05). Multivariate Logistic regression analysis showed that the decrease of PCHD-ASPECT score and the increase of maximum iodine concentration were risk factors for HT after EVT in AIS patients(P<0. 05). AUC of iodine concentration of PCHD was higher than that of PCHD-ASPECT score are 0. 909 and 0. 899.Conclusion The PCHD-ASPECT score and iodine concentration based on spectral CT have high value in predicting HT after EVT in AIS patients.更多还原