彩色多普勒超声联合CTA检查对脑梗死患者颅外颈动脉斑块性质的诊断价值  

Value of Ultrasound Combined with CTA in the Diagnosis of Extracranial Carotid Plaque in Patients with Cerebral Infarction

作　　者：张伟 李华 张书超[3] ZHANG Wei;LI Hua;ZHANG Shu-chao(Department of Functional,Hebei Geriatric Hospital,Shijiazhuang 050000,Hebei Province,China;Department of Functional,The Second Outpatient Department of Hebei Province,Shijiazhuang 050051,Hebei Province,China;Department of Radiology,Hebei Geriatric Hospital,Shijiazhuang 050000,Hebei Province,China)

机构地区：[1]河北省老年病医院功能科,河北石家庄050000 [2]河北省直属机关第二门诊部功能科,河北石家庄050051 [3]河北省老年病医院放射科,河北石家庄050000

出　　处：《中国CT和MRI杂志》2021年第3期20-23,共4页Chinese Journal of CT and MRI

基　　金：河北省2019年度医学科学研究课题计划(20190977)。

摘　　要：目的研究彩色多普勒超声联合电子计算机断层扫描血管造影(CTA)检查对脑梗死患者颅外颈动脉斑块性质的诊断价值。方法选择2016年8月至2018年8月我院收治的98例有颈动脉斑块的脑梗死患者作为研究对象。所有患者均在发病一周内进行彩色多普勒超声及CTA检查,同时随机选择40例患者进行数字减影血管造影(DSA)检查,比较彩色多普勒超声及CTA检查颈动脉狭窄程度、斑块检出及斑块位置检出情况,并与DSA检查对比。结果 98例进行彩色多普勒超声及CTA检查的患者共检查血管数588根,同时40例进行DSA检查的患者检查血管240根,CTA及DSA检查对不同程度颈动脉狭窄检出率均高于彩色多普勒超声检查,差异具有统计学意义(P<0.05);彩色多普勒超声与CTA检查在轻度与中度颈动脉狭窄的诊断上一致性较低,在重度与完全闭塞颈动脉狭窄的诊断上一致性较强;98例患者中,彩色多普勒超声检出斑块135个,CTA检查检出斑块149个,同时40例进行DSA检查的患者中,检出斑块88个,CTA检查在颈内动脉斑块检出率明显高于彩色多普勒超声检查,差异具有统计学意义(P<0.05);彩色多普勒超声与CTA检查在软斑、扁平斑、硬斑及溃疡性混合斑的检出上一致性较强;彩色多普勒超声与CTA检查在颈总动脉及颈总动脉分叉处的斑块检出上一致性较强。结论通过与DSA检查结果比较,彩色多普勒超声与CTA检查在诊断脑梗死患者颅外颈动脉斑块性质、发生部位及颈动脉狭窄程度上各具优势,结果一致性良好,联合检测具有较高的诊断价值,值得临床推广应用。Objective To investigate the value of ultrasound combined with computed tomography angiography(CTA) in the diagnosis of extracranial carotid plaque in patients with cerebral infarction.Methods 98 patients with cerebral infarction with carotid plaque admitted to our hospital from August 2016 to August 2018 were selected,and received the ultrasound and CTA examinations within one week of onset.At the same time,40 patients were randomly selected for digital subtraction angiography(DSA).The detection rates of carotid artery stenosis,plaque and plaque location by ultrasound,CTA and DSA were compared.Results A total of 588 vessels were examined in 98 patients undergoing ultrasound and CTA examination,while 240 vessels were examined in 40 patients undergoing DSA examination.The detection rate of carotid artery stenosis by CTA and DSA was higher than that by ultrasound(P<0.05).Ultrasound and CTA were less consistent in the diagnosis of mild and moderate carotid stenosis and more consistent in the diagnosis of severe and complete occlusion carotid stenosis.Among the 98 patients,135 plaques were detected by ultrasound,149 by CTA,and 88 plaques were detected by DSA in 40 patients.The detection rate of internal carotid artery plaque by CTA was significantly higher than that by ultrasonic examination(P<0.05).Ultrasound and CTA were consistent in detecting soft plaque,flat plaque,hard plaque and ulcerative mixed plaque.Ultrasound and CTA were also consistent in the detection of plaques at the bifurcation of common carotid artery and common carotid artery.Conclusion Compared with the results of DSA,ultrasound and CTA have advantages in the diagnosis of extracranial carotid plaque,location and degree of carotid stenosis in patients with cerebral infarction.The results of the two methods are consistent,moreover,the combined detection has higher diagnostic value than the single detection and is worthy of clinical application.

关 键 词：彩色多普勒超声 CTA 联合检查 脑梗死 颈动脉斑块 

分 类 号：R445.1[医药卫生—影像医学与核医学] R445.3[医药卫生—诊断学]