摘要目的 对比分析引起脑供血不足的高危因素,探讨热断层扫描成像(TTM)技术在脑供血不足诊断及筛查中的应用价值.方法 选择8787例健康体检受检者为研究对象,收集一般资料,并完成血压、血脂、颈椎X线、劲动脉超声多普勒、头颅磁共振成像(MRI)和TTM检查.按TTM检查脑供血不足的结果将研究对象进行分组,对比分析引起脑供血不足的高危因素.将TTM脑供血不足检查结果与MRI脑缺血灶诊断结果进行比较.结果 8787例研究对象中有3734例(42.49％)存在脑供血不足(TTM阳性组),5053例(57.51％)无明显异常(TTM阴性组).两组间各项高危因素指标(肥胖、低密度脂蛋白胆固醇异常、吸烟、嗜酒、高血压、多发脑缺血灶、颈动脉硬化)比较,差异均具有统计学意义(均P<0.01).以MRI诊断脑缺血灶为标准,TTM检查脑供血不足的敏感度为84.63％,特异度为65.17％,阳性预测值为30.66％,阴性预测值为95.88％.结论 TTM检查不仅能较早发现脑供血不足状态,还能在形态学检查发现引起脑供血不足的器质性组织结构改变前对脑供血不足发生趋势作出准确评价,是健康管理中对脑供血不足预防干预的重要预警指标.

abstractsObjective To compare and analyze the risk factors of cerebral insufficiency, and to explore the application of thermal texture maps (TTM) in the diagnosis and screening of cerebral insufficiency. Methods 8787 healthy subjects were selected as the research object, and theit clinical data were collected, including blood pressure, blood lipid, X-ray of cervical vertebra, Doppler ultrasound of the stiff artery, cranial magnetic resonance imaging (MRI) and TTM examination. Subjects were grouped according to the results of TTM examination of cerebral insufficiency, and high risk factors for cerebral insufficiency were comparatively analyzed. The results of TTM and MRI in diagnosis of cerebral ischemia were comparative analysis. Results Among the 8787 subjects, 3734 subjects (42.49％) had cerebral insufficiency (TTM positive group), and 5053 (57.51％) had no significant abnormalities (TTM negative group). The differences between the two groups in high risk factors were statistically significant, including obesity, abnormal low density lipoprotein cholesterol, smoking, alcoholism, hypertension, multiple cerebral ischemia and carotid atherosclerosis (all P<0.01). By taking the MRI as the gold standard, the sensitivity, specificity, positive and negative predictive value of brain blood supply TTM for diagnosing focal cerebral ischemia was 84.63％, 65.17％, 30.66％ and 95.88％, respectively. Conclusions TTM can be an important early warning index of cerebral insufficiency in disease despreventive and intervention.