缺血性脑血管病的头颈动脉CTA评价  

Evaluation of Ischemic Cerebrovascular Disease with CT Angiography of Head and Neck

作　　者：杨斌[1] 吴最新[1] 俞一歆[1] 单艳娜[1] 牛国忠[2] 

机构地区：[1]杭州市第一人民医院放射科,杭州310006 [2]杭州市第一人民医院神经内科,杭州310006

出　　处：《放射学实践》2007年第10期1033-1037,共5页Radiologic Practice

摘　　要：目的:探讨缺血性脑血管病患者颅内外动脉狭窄的特征及头颈动脉CTA的应用价值。方法:对172例缺血性脑血管病患者,其中脑梗死79例,TIA93例,采用头颈动脉CTA检查,分析其颅内外动脉狭窄的特点及其与脑梗死类型的关系。结果:164例患者头颈动脉多层CTA图像满足诊断要求,125例显示有颅内外动脉狭窄,其中单纯脑动脉狭窄74例(59%)、单纯颈动脉狭窄32例(26%),颈和脑动脉狭窄并存19例(15%)。单纯脑动脉狭窄、颈和脑动脉狭窄并存发生率在脑梗死组较TIA组高,其中颈和脑动脉狭窄并存发生率两组间差异有显著性意义。大面积脑梗死及分水岭脑梗死的部位与颅内外动脉狭窄程度、侧别及Willis环有一定的相关性。基底节区、半卵圆中心、皮层区腔隙性脑梗死的部位与颅内外动脉狭窄程度、侧别间无明确相关性。结论:缺血性脑血管病患者的颅内外动脉狭窄发生率均较高。单纯脑动脉狭窄、颈和脑动脉狭窄并存是脑梗死的重要危险因素。颅内外动脉狭窄程度、侧别及Willis环与脑梗死类型有一定的相关性。头颈动脉多层CTA可以同时准确评价颅内外动脉的病变情况,具有重要临床价值。Objective：To study the character of extra- and intracranial artery stenosis in patients with ischemic cerebrovascular disease and the application of CT angiography of head and neck. Methods： 172 cases of ischemic cerebrovascular disease including 79 patients with infarction, 93 patients with transient ischemic attack were analysed the findings of stenosis and occlusion of extra- and intracranial artery and it＇s relationship with the type of infarction. Resuits：CT angiography of 164 cases （95 G） were satisfied with diagnosis. Artery stenosis was found in 125 cases. Among them, there were 74 cases of stenosis of cerebral artery, 32 cases of carotid stenosis, 19 cases of co-occurrence of carotid and cerebral artery stenosis. The frequency of cerebral artery stenosis and co-occurrence of carotid and cerebral artery stenosis was higher in infarction group than TIA group,there was significant difference between the two group for the frequency of co-occurrence of carotid and cerebral artery stenosis. The position and degree of artery stenosis was correlated to the large area cerebral infarction and watershed infarction,but it was of no significant correlation with the lacuna infarction within the region of basal ganglia, centrum semiovale and cortex. Conclusion：The frequency of both extra- and intracranial artery stenosis are high in patients with ischemic cerebrovascular disease. Cerebral artery stenosis and co-occurrence of carotid and cerebral artery stenosis are important risk factors for cerebral infarction. The position and degree of extra- and intracranial artery stenosis and circle of Willis are correlated to the type of cerebral infarction in a certain extent. CT angiography of head and neck can be useful in detection of extra- and intracranial artery stenosis simultaneously.

关 键 词：脑血管障碍 脑缺血发作 短暂性 脑动脉疾病 体层摄影术 X线计算机 

分 类 号：R743[医药卫生—神经病学与精神病学]