To investigate the value of CT perfusion imaging combined with CT angiography in predicting the progression of transient ischemic attack (TIA) to acute cerebral infarction (ACI).

150 patients with TIA admitted to our hospital from March 2019 to August 2022 were selected. All patients underwent CT perfusion imaging and CT angiography within 24 hours after admission. They were divided into ACI group and non-ACI group according to whether ACI occurred within 7 days after the onset of the disease. CT perfusion imaging parameters [cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), time to peak (TTP)] and angiographic characteristics were compared between ACI group and non-ACI group. Draw receiver operating characteristic (ROC) curve to analyze the predictive value of CT perfusion imaging combined with CT angiography for TIA patients' progression to ACI.

The incidence of ACI in TIA patients was 18.67% (28/150). CBV and CBF in ACI group were lower than those in non ACI group (P < 0.05), and MTT and TTP were higher than those in non ACI group (P < 0.05). The degree of vascular stenosis in ACI group was higher than that in non ACI group (P < 0.05). The sensitivity, specificity and area under the curve (AUC) of CBV, CBF, MTT and TTP in predicting the progression of TIA patients to ACI were 78.57%, 88.52% and 0.824 respectively, and the AUC predicted by CBV, CBF, MTT and TTP was higher than that predicted alone. The AUC and sensitivity of CT perfusion imaging combined with CT angiography in predicting the progression of TIA to ACI were higher than those predicted alone (P < 0.05), but there was not statistically significant compared with that predicted alone (P > 0.05).

CT perfusion imaging and CT angiography have a certain predictive value for the progression of TIA patients to ACI, but the combined predictive value is higher.