Objective To investigate the relationship between clinical CT perfusion imaging(CTPI) parameters and prognosis of acute cerebral infarction after conventional medical treatment.

Methods The relevant data of patients diagnosed with acute cerebral infarction within 24 hours of onset, who underwent CTPI examination without arterial thrombectomy or intravenous thrombolysis, were collected.The NIHSS was used as an evaluation index of clinical neurological impairment, and the patients were evaluated at the time of onset.Patients with scores 4-25 points were selected.The modified Rankin scale(mRS) was used to follow up at 90 days after the onset of the disease.The patients with mRS < 3 and mRS≥3 were divided into the good prognosis group and poor prognosis group, respectively.The CTPI parametersincluding the mean transit time(MTT), time to peak (TTP), cerebral blood flow(CBF) and cerebral blood volume(CBV) in two groups were recorded and analyzed to determine whether there was a significant correlation between the change of CTPI parameters on the affected side and prognosis of the patients, and whether there was a significant difference in the prediction of the prognosis of cerebral infarction by CTPI parameters on the affected side, and further determine whether CTPI parameters could accurately predict the prognosis of cerebral infarction.

Results In the poor prognosis group, the CBV and CBF on the affected side were lower than those on healthy side, while the MTT and TTP were longer than those on healthy side, and the differences were statistically significant (P < 0.01).The CBF and MTT on the affected side in the good prognosis group were lower and longer MTT than those on healthy side (P < 0.01 and P < 0.05).However, there was no statistical significance in the CBV and TTP between the affected side and healthy side (P>0.05).The CBV and CBF of the affected side in the poor prognosis group were lower than those in good prognosis group, while the MTT and TTP were longer than those in good prognosis group (P < 0.05 to P < 0.01).However, there was no statistical significance in various parameters on the healthy side between two groups(P>0.05).The results of multivariate logistic regression analysis showed that the CBF parameter was more accurate in predicting the prognosis of cerebral infarction.The higher the CBF, the greater the likelihood of a good prognosis for patients with cerebral infarction.

Conclusions The parameters of CTPI are closely related to the prognosis of cerebral infarction, and the CBF parameter has the greatest value in predicting the prognosis of cerebral infarction.It can quickly predict the prognosis of cerebral infarction in the early stage to provide the important basis for clinical staff in neurology to choose treatment plans, judge and improve prognosis.