ISSN 1004-4140
    CN 11-3017/P

    动脉输入函数洗脱相截断对CT脑灌注结果准确性影响的定量研究

    A Quantitative Investigation of the Influence of Arterial Input Function Washout Phase Truncation on the Accuracy of Brain CT Perfusion Results

    • 摘要: 目的:探讨动脉输入函数(AIF)洗脱相(Washout phase)截断对CT脑灌注(CTP)结果准确性的影响,确立AIF曲线完整性判断标准,首次建立AIF峰值与后基线水平的定量关系模型,为CTP质量控制提供精准量化依据。方法:回顾性纳入2023年1月至2024年1月疑似急性前循环缺血性卒中且AIF曲线完整(后基线时长≥18 s)的患者34例。以AIF峰值后下降支第一个低点为时间零点,零点后持续采集18 s对应的灌注参数(缺血核心体积、低灌注区体积)为“金标准”,通过逐步模拟截断法确定“最佳扫描时长”(参数与金标准相对偏差≤10%的最晚截断时长);采用线性回归分析探究AIF峰值CT值与后基线平均CT值的关联,构建预测模型。结果:79.4%(27/34)患者的“最佳扫描时长”位于时间零点之后。正态性检验显示最佳扫描时长呈偏态分布,分位数分析显示,50百分位数(P50)、75百分位数(P75,临床推荐值)、90 百分位数(P90)对应的零点后最佳持续扫描时间分别为9.0、12.0和15.0 s。首次发现AIF峰值CT值与后基线平均CT值呈极强正相关(r=0.800,P < 0.001),回归模型为:后基线CT值=0.18×AIF峰值CT值+23.59(R2=0.639,F=56.700,P < 0.001),模型拟合良好。结论:AIF洗脱相完整采集需在时间零点后至少持续扫描12s可覆盖75%的患者以满足临床质控需求,15s可覆盖90%以上患者;首次建立的回归模型为评估已完成扫描的AIF曲线完整性、判断截断程度及未来智能化质控提供了量化依据。

       

      Abstract: Objective: To provide a precise quantitative basis for computed tomography perfusion (CTP) quality control by investigating the impact of arterial input function (AIF) washout phase truncation on the accuracy of CTP results, establishing criteria for determining AIF curve integrity, and constructing the first quantitative relationship model between AIF peak and post-baseline levels. Methods: A retrospective analysis was conducted on 34 patients with suspected acute anterior circulation ischemic stroke who underwent CTP from January 2023 to January 2024, and had complete AIF curves (post-baseline duration ≥18 s). The first low point of the descending branch after the AIF peak was defined as time zero. The perfusion parameters corresponding to the complete 18 s post-zero data were used as the “gold standard”. The “optimal scan duration” (defined as the latest truncation time with a relative deviation of parameters from the gold standard ≤10%) was determined using a stepwise simulated truncation method. Linear regression was applied to analyze the correlation between the AIF peak CT value and post-baseline average CT value. Results: The “optimal scan duration” in 79.4% (27/34) of patients was after time zero. This metric showed a skewed distribution. Quantile analysis revealed that the optimal continuous scanning times after time zero corresponding to the 50th percentile (P50), 75th percentile (P75, recommended clinical value), and 90th percentile (P90) were 9.0 s, 12.0s, and 15.0 s, respectively. A strong positive correlation was found between the AIF peak CT value and post-baseline average CT value (r=0.800, P < 0.001). The regression model was as follows: Post-baseline CT value=0.18×AIF peak CT value+23.59 (R2=0.639, P < 0.001). Conclusion: Complete acquisition of the AIF washout phase requires continuous scanning for at least 12 s after time zero to encompass 75% of patients for routine quality control, while 15 s can cover more than 90% of patients. The established regression model provides a quantitative tool for evaluating AIF curve integrity and further offers a theoretical basis for future intelligent AI-based quality control.

       

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