颈动脉超声及CT测定粥样斑块诊断缺血性脑卒中的作用  

The Role of Carotid Ultrasound and CT in the Diagnosis of Cerebral Ischemic Stroke

作　　者：张新艳[1] 姜国清[1] ZHANG Xin-yan;JIANG Guo-qing(Physical Examination Center,Jiamusi Central Hospital,Jiamusi 154002,Heilongjiang,China)

机构地区：[1]佳木斯市中心医院体检中心,黑龙江佳木斯154002

出　　处：《医学信息》2020年第21期160-162,共3页Journal of Medical Information

摘　　要：目的探讨颈动脉彩超对粥样斑块的诊断效果及对缺血性脑卒中的预防价值。方法回顾性分析2016年3月~2019年1月在黑龙江省佳木斯市中心医院接受治疗的缺血性脑卒中患者80例的临床资料,均给予CT和颈动脉彩超检查,分析颈动脉粥样斑块的超声病理学分型与斑块分布及检出率情况。结果本研究DSA检查检出颈动脉狭窄80个;椎动脉狭窄与发育异常73个;腔隙性脑梗死70个;动脉粥样硬化性斑块73个;斑块病理分型以扁平斑居多,溃疡斑最少,而斑块分布以颈动脉分窦部(BIF)处最多,颈内动脉(ICA)处最少,且右侧斑块较左侧多;颈动脉彩超对颈动脉狭窄、腔隙性脑梗死、椎动脉狭窄与发育异常、动脉粥样硬化性斑块的检出与DSA的一致性为0.896,高于CT的0.720。结论采用颈动脉彩超检测与DAS一致性较好,可准确诊断出缺血性脑卒中患者粥样斑块病理类型、分布及数量,CT检测一致性一般,采用颈动脉彩超检测有利于早期评估斑块发生的危险因素,为早期预防及制定治疗措施提供有效依据。Objective To explore the diagnostic effect of carotid artery color Doppler ultrasound on atherosclerotic plaque and its preventive value for cerebral ischemic stroke.Methods The clinical data of 80 patients with cerebral ischemic stroke who were treated in Jiamusi Central Hospital in Heilongjiang Province from March 2016 to January 2019 were retrospectively analyzed.CT and carotid artery color Doppler ultrasound examination were performed to analyze carotid atheroma ultrasonic pathological classification and plaque distribution and detection rate of lumps.Results In this study,DSA examination detected 80 carotid artery stenosis;73 vertebral artery stenosis and dysplasia;70 lacunar cerebral infarction;73 atherosclerotic plaques;the majority of plaque pathological types were flat plaques.Ulcer plaques were the least,and plaques were distributed in the carotid sinus(BIF)the most,the internal carotid artery(ICA)was the least,and there were more plaques on the right side than on the left;The consistency of the detection of cerebral infarction,vertebral artery stenosis and dysplasia,and atherosclerotic plaque with DSA was 0.896,which was higher than the CT's 0.720.Conclusion The carotid artery color Doppler ultrasound detection was consistent with DAS,which could accurately diagnose the pathological type,distribution and number of atherosclerotic plaques in patients with cerebral ischemic stroke.The consistency of CT detection was general.The use of carotid artery color Doppler ultrasound detection was beneficial to early assessment of plaques the risk factors of block occurrence provided an effective basis for early prevention and formulation of treatment measures.

关 键 词：缺血性脑卒中 粥样斑块 颈动脉彩超 

分 类 号：R743.3[医药卫生—神经病学与精神病学]