颈动脉粥样斑块的多排螺旋CT血管造影及流行病学分布特征  

The MDCTA Findings and Clinical Epidemiology of Carotid Artery Atherosclerostic Plaques

作　　者：周建军[1] 周康荣[1] 陈祖望[1] 王建华[1] 曾蒙苏[1] 严福华[1] 陈刚[1] 张利军[1] 陈锦[1] 缪熙音[1] 

机构地区：[1]复旦大学附属中山医院放射科,上海200032

出　　处：《放射学实践》2006年第4期336-339,共4页Radiologic Practice

基　　金：卫生部博士点基金资助(9741)

摘　　要：目的:分析150例颈动脉粥样斑块病例,探讨其MDCTA表现及其临床流行病学分布特征。方法:经大范围MDCTA检查的颈动脉粥样斑块150例,所有病例均行彩色多谱勒超声检查,29例行DSA检查。应用横断面图像寻找斑块,根据病变的特点行2D、3D后处理,探讨其分布、形态、狭窄程度、钙化、不规则及溃疡等规律。根据斑块的钙化和纤维帽的完整性作为斑块风险性的评价指标,狭窄程度的判断采用NASCET标准。结果:150例病例中共发现317处斑块,其中,颈动脉起始部斑块37例,颈总动脉28例,颈动脉分叉部173例,颈内动脉44例,颈外动脉35例。轻、中、重狭窄及闭塞的发病率分别为30.95%、49.41%、16.96%及3.87%。分叉段斑块钙化率为64.7%,分叉段以外区域为23.9%。分叉段斑块不规则和溃疡的发病率为16.8%,分叉段以外为15.95%。分叉段狭窄程度以轻中度狭窄为主;分叉段以外以中重度狭窄比例高。结论:颈动脉不同区域粥样斑块的分布、形态、钙化和狭窄程度差异存在显著性意义,高风险斑块发病率相似,局限于分叉段的颈动脉检查可能漏诊高风险斑块。Objective.. To investigate the MDCTA findings and clinical epidemiology of carotid Artery atherosclerostic plaques by analyzing 150 cases with atherosclerostic plaques. Methods： 150 cases with atherosclerostic plaques underwent large extent MDCTA and CDS examination, 29 of which underwent DSA examination. Results.. 317 plaques shown by the images were distributed in different areas as the following., the initiated part of carotid artery 37, the common carotid artery 28, carotid artery bifurcation 173 ,the internal carotid artery 44 and the external carotid artery 35. The incidence of slight,medium,high degree of stenosis and occlusions were 30.95 %, 49.41%, 16.96 % and 3.87 % respectively. The incidence of calcification occurred in the carotid artery artery bifurcation level was 64.7% with slight or medium degree of stenosis. In contrast, beyond the bifurcation, the incidence of calcification was 23.9% with medium and high degree of stenosis. The irregular and ulcer of the plaque has no obvious difference among them. Conclusion：Atherosclerostic plaques in carotid artery are distributed in any areas with the difference between the incidence of soft plaque and the degree of stenosis. Large extent carotid artery MDCTA is valuable in the diagnosis of atherosclerostic plaques.

关 键 词：颈动脉 血管造影 粥样斑块 流行病学 体层摄影术 X线计算机 

分 类 号：R816.1[医药卫生—放射医学]