症状性颈动脉狭窄患者颈动脉斑块内成分的CT能谱分析  

CT energy spectrum of carotid plaques in symptomatic carotid stenosis patients

作　　者：陈蓓蕾 徐俊 李晓波 叶靖 吕朋华 CHEN Bei lei XU Jun LI Xiao bo et al(Department of Neurology, Northern Jiangsu People＇s Hospital ,Yangzhou 225009 ,Jiangsu Province, Chin)

机构地区：[1]苏北人民医院神经内科,扬州225009

出　　处：《中华老年心脑血管病杂志》2017年第4期391-394,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：国家自然科学基金(81471215;81271211);江苏省自然科学基金(BK20151592);江苏省科技项目(BE2015665)

摘　　要：目的探讨CT能谱分析检测症状性颈动脉狭窄患者斑块内成分的准确性。方法通过CT血管成像筛选出狭窄程度>70%的症状性颈动脉狭窄患者32例,并对斑块内结构进行CT能谱分析,获取感兴趣区的能谱曲线,与纤维、脂肪等物质的标准曲线对比,推断出斑块内的组织成分。选择部分患者接受颈动脉内膜剥脱术,获得颈动脉斑块进行病理分析。比较CT能谱分析与斑块病理分析结果的一致性。结果 32例患者均接受颈动脉内膜剥脱术,共获得32枚颈动脉斑块,其中Ⅱ型斑块3枚,Ⅲ型斑块5枚,Ⅳ型斑块6枚,Ⅴ型斑块18枚。病理检查与CT能谱分析检测富含脂质的斑块、纤维帽破损斑块以及斑块内钙化比较,差异无统计学意义(P>0.05)。结论 CT能谱分析能较准确的评估颈动脉斑块的稳定性,指导缺血性脑卒中预防和治疗工作的开展。Objective To study the accuracy of CT energy spectrum in detecting carotid plaques in symptomatic carotid stenosis patients. Methods Thirty symptomatic carotid stenosis patients with their carotid stenosis 〉70% detected by CT angiography were included in this study. The energy spectrum curves for regions of interest were obtained by analyzing the carotid plaques and compared with the standard spectrum curves for fiber and fat. The pathology of carotid plaques was analyzed. The consistency of energy spectrum analysis and pathological analysis of the plaques was compared. Results Of the 32 plaques detected in carotid endarterectomy,3 were type Ⅱ ,5 were typeⅢ ,6 were type Ⅳ and 18 were typeV. Lipid-rich plaques,plaques with damaged fiber caps and calcified plaques were detected by CT energy analysis and pathological analysis （P〉 0.05）. Conclusion CT energy spectrum can accurately assess the stability of carotid plaques and can thus guide the prevention and treatment of ischemic stroke.

关 键 词：颈动脉狭窄 体层摄影术 X线计算机 颈动脉内膜切除术 

分 类 号：R743[医药卫生—神经病学与精神病学]