缺血性脑血管病颈动脉狭窄15例影像诊断  

Imaging Diagnosis of Ischemic Cerebrovascular Disease due to Carotid Stenosis──A Report of 15 Cases

作　　者：鲁晓燕[1] 张挽时[1] 喻敏[1] 时惠平[1] 郭华朝[2] 郭英[1] 

机构地区：[1]北京空军总医院磁共振科,100036 [2]北京空军总医院超声诊断科,100036

出　　处：《临床放射学杂志》2001年第6期409-412,共4页Journal of Clinical Radiology

摘　　要：目的　评价颈动脉狭窄无创性影像学检查方法的临床应用价值 ,探讨颈动脉狭窄与缺血性脑血管病之间的联系。材料与方法　对 15例 3 0支颈动脉行多普勒超声 (DUS)、磁共振血管造影 (MRA)及头部CT、MRI检查。其中 5例同时行颈动脉CT血管造影 (CTA) ,4例与DSA对照 ,6例颈动脉重度狭窄者行颈动脉内膜切除术。结果　 15例 3 0支颈动脉 ,轻度狭窄 ( <3 0 % ) 8支 ,中度狭窄 ( 3 0 %～ 69% ) 6支 ,重度狭窄 ( 70 %～ 99% ) 8支 (均为一侧 ) ,闭塞 2支 ,未见狭窄 6支。 8支颈动脉重度狭窄者狭窄侧腔隙性脑梗死 5例 ,狭窄对侧皮层梗死 1例 ,双侧脑梗死 1例 ,未见异常 1例。颈动脉闭塞侧大脑中动脉分布区脑梗死 2例。CTA显示硬化斑块 3例。结论　颈动脉狭窄与脑梗死的发生、发展密切相关。DUS、MRA、CTA结合使用能够在颈动脉狭窄的筛选、诊断、监测中发挥重要作用。Objective To evaluate non invasive imaging techniques in the diagnosis of carotid stenosis and to study the relationship between the carotid stenosis and cerebral infarction. Materials and Methods Doppler ultrasound (DUS), MR angiography (MRA) were performed for 30 carotid arteries of 15 patients, while CT and MRI scanning of the brain were done simultaneously. Additional CT angiography (CTA) was made in 5 patients, the results in 4 of which were compared with that of DSA. Carotid endarterectomy was carried out in 6 patients with severe stenosis. Results Of 30 carotid arteries, mild stenosis was seen in 8, moderate in 6, severe in 8, obstructed in 2 and normal in 2. In cases with severe carotid stenosis, more infarction lesions were demonstrated on the ipsilateral cerebral hemisphere. Large infarction of the middle cerebral artery distribution was seen in 2 cases with carotid occlusion. Atheromatous plaques were well delineated on CTA.Conclusion A strong link exists between the carotid stenosis and cerebral infarction. A combination of DUS, MRA and CTA is of great help in the screening, diagnosing and monitoring of carotid stenosis.

关 键 词：缺血性脑血管病 颈动脉狭窄 磁共振血管造 CT 诊断 

分 类 号：R816.1[医药卫生—放射医学]