颈动脉斑块CT血管成像在缺血性脑卒中患者中的应用  

Application of CT angiography of carotid atherosclerotic plaque in patients with ischemic cerebral stroke

作　　者：郑玉飞[1] 朱丽丽[1] 王卓群[1] 徐辉[2] 

机构地区：[1]句容市人民医院CT/MRI室,江苏212400 [2]南京医科大学附属南京医院放射影像科,江苏210000

出　　处：《中国临床新医学》2014年第11期1018-1021,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的通过分析颈动脉斑块64排CT血管成像特点,探讨不同类型颈动脉斑块与缺血性脑卒中的相关性。方法回顾分析60例缺血性脑卒中患者头颈部64排CT血管成像资料,轴位原始图像结合容积再现(VR)及曲面重建(CPR),观察颈动脉斑块的分布、性质及形态特征,测量颈动脉狭窄程度。结果 60例缺血性脑卒中患者中,58例存在颈动脉斑块,共发现斑块228块,其中非钙化斑块43块,钙化斑块125块,混合斑块60块。60例患者中颈动脉出现轻度狭窄170处,中度狭窄20处,重度狭窄12处,闭塞1处,管腔未见明显狭窄20处。颈内动脉颅内段有5处钙化斑块,CT无法评价其狭窄程度。非腔隙性脑梗死与腔隙性脑梗死患者不稳定性斑块及稳定性斑块构成比差异有统计学意义(P<0.05及0.01)。结论 64排CT血管成像能够准确判断颈动脉斑块的分布、性质、形态特征及颈动脉的狭窄程度,对缺血性脑卒中的预防、治疗及预后的判断具有重要价值。Objective To analysis 64-slice CT angiography imaging features of carotid atherosclerotic plaque and explore the relationship between different types of carotid atherosclerotic plaque and ischemic cerebral stroke. Methods The clinical data of 60 cases of ischemic cerebral stroke were retrospectively analyzed, all the cases were underwent 64-detector row CT angiography, and the distribution, character and morphological characteristics of carotid atherosclerotic plaque, and morphological characteristics and the extent of stenosis were observed with the original ax -ial image,volume rendering （ VR） and curved planar reconstruction （ CPR）. Results In the 60 cases of ischemic cer-ebral stroke,58 cases with carotid atherosclerotic plaque were found. A total of 228 plaques were detected, including 43 non-calcified plaque, 125 calcified plaque and 60 mixed plaque. In 60 cases, 170 mild stenosis, 20 moderate ste-nosis, 12 severe stenosis and 1 occlusion were found, no significant stenosis were found in 20 sites. Five calcified plaques were found in intracranial segment of internal carotid artery, and CT can′t evaluate the severity of the steno-sis. There was significantly statistical difference in unstable plaque between non-lacunar infarct and lacunar infarct （P〈0. 05 ）. Conclusion 64-detector row CT angiography of carotid atherosclerotic plaques can accurately detect the dis -tribution, character and morphological characteristics of carotid atherosclerotic plaque and the degree of stenosis of ca -rotid artery,it is a valuable method in prevention, treatment, and prognosis judgement of ischemic cerebral stroke.

关 键 词：X线计算机体层摄影术 血管造影术 缺血性脑卒中 

分 类 号：R445[医药卫生—影像医学与核医学]