应用弓上CTA成像评估缺血患者颈动脉粥样硬化斑块的临床研究  

A Clinical Study of Carotid Atherosclerotic Plaques in Ischemic Patients Using CT Angiography

作　　者：隋滨滨[1,2] 高培毅[1,2] 林燕[1,2] 荆利娜[1,2] 薛静[1,2] 顾卫彬[1,2] 

机构地区：[1]首都医科大学附属北京天坛医院 [2]北京市神经外科研究所放射科,100050

出　　处：《医学研究杂志》2013年第12期42-46,共5页Journal of Medical Research

基　　金：北京市自然科学基金资助项目(7133238);北京市优秀人才培养基金资助项目(2011D003034000024)

摘　　要：目的评价缺血性患者颈动脉粥样硬化斑块CTA成像特点以及CTA成像在临床中的应用价值。方法收集37例存在颈动脉斑块的缺血症状患者，年龄48～86岁，平均年龄64．4±8．6岁；男性30例，女性7例。CT血管成像（CTangiography，CTA）应用宝石能谱CT，所得原始图像应用三维重建技术分析。测量血管狭窄率、斑块CT密度，评估斑块钙化程度和表面形态。结果37例患者共有67支血管于颈动脉分叉部发现斑块，斑块平均密度CT值约为53．4±19．4HU，最大密度平均值约为69．7±20．2HU，最小密度平均值约为41．4±22．5HU。斑块无钙化者9支，I级钙化26支，Ⅱ级钙化23支，Ⅲ级钙化9支。斑块表面形态呈光滑型37支，表面不规则型20支，表面溃疡型10支。责任侧与非责任侧血管组比较，血管狭窄率（P=0．039）、斑块平均密度值（P=0．040）及斑块最小密度值（P=0．037）之间差异存在统计学意义。两组间斑块钙化分级存在统计学差异（P=0．033），斑块表面形态未见明显统计学差异（P=0．125）。结论CT血管成像在检测和评估颈动脉粥样硬化斑块方面存在重要的临床应用价值。缺血责任侧血管与非责任侧血管之间的狭窄率、斑块性质之间存在一定的差别。Objective To assess the application value of CT angiography and to evaluate the features of carotid atherosclerotic plaques in ischemic patients using CTA. Methods Thirty seven ischemic patients （30 male, 7 female, mean age ：64.4 ＋ 8.6years） with carotid plaques were recruited. Gemstone spectral CT was applied to obtain CTA source images, with three dimensional post - processing technique being used. The stenosis degree, CT value of plaques, calcification degree, and surface status of plaques were measured and classified. Results In total 67 carotids with plaques were analyzed. The mean CT value, maximum CT value and minimum CT value of plaques was 53.4 ~ 19.4HU, 69.7 ~ 20.2HU, and 41.4 ~ 22.5HU, respectively. There were 9 carotids without calcification, 26 with I degree, 23 with II degree, and 9 with Ill degree. The surface status of the plaques were classified as smooth （n = 37） , irregular （n = 20） , and ulceration （ n = 10） types. There was significant difference in stenosis degree （ P = 0. 039 ） , mean CT value of plaques （ P = 0. 04） and minimum CT value （ P = 0. 037）, calcification degree （ P = 0. 033 ） between index side and non - index side carotids ; while no significant difference was found in surface status between index side and non - index side carotids （P = 0. 125 ）. Conclusion CTA haspotential important application value in detection and evaluation of carotid plaques. There was difference between stenosis degree and plaque features between index and non -index carotids in ischemic patients.

关 键 词：计算机断层扫描 CT血管成像 颈动脉 动脉粥样硬化斑块 

分 类 号：R543.4[医药卫生—心血管疾病]