CT头颈部成像联合颈动脉超声对血管性帕金森患者的诊断价值  

Diagnostic Value of CT Cerebral and Carotid Arteriography Combined with Carotid Artery Ultrasound in Patients with Vascular Parkinson's Disease

作　　者：沈瑾[1] 李明辉 刘珂 SHEN Jin;LI Ming-hui;LIU Ke(Department of Neuroelectrophysiology,Shanghai Tenth People's Hospital,Shanghai 200072,China;Department of Diagnosis and Treatment,Shanghai Fifth Rehabilitation Hospital,Shanghai 201600,China)

机构地区：[1]上海市第十人民医院神经电生理室,上海200072 [2]上海市第五康复医院诊疗科,上海201600

出　　处：《中国CT和MRI杂志》2022年第2期32-35,共4页Chinese Journal of CT and MRI

摘　　要：目的分析CT头颈部成像联合颈动脉超声对血管性帕金森患者的诊断价值。方法选取我院2018年3月至2019年10月收治的血管性帕金森患者100例,分别接受CT头颈部成像、颈动脉超声,以数字减影血管造影检查(DSA)作为“金标准”。分析CT头颈部成像、颈动脉超声及联合诊断的脑部病变部位、改良Hoehn-Yahr分期、头颈部动脉狭窄程度及颈动脉斑块类型阳性率并计算诊断价值。结果头颈部CT、颈动脉超声、联合诊断方法判断改良Hoehn-Yahr分期0期、1期、2期、3期、4期阳性率差异比较有统计学意义(P<0.05)。阳性率由高到低依次是联合诊断、颈动脉超声、头颈部CT。头颈部CT、颈动脉超声、联合诊断血管性帕金森病脑部病变部位皮质下白质、基底核、丘脑阳性率差异比较有统计学意义(P<0.05)。头颈部CT、颈动脉超声、联合诊断血管性帕金森病头颈部动脉狭窄程度正常、轻度狭窄、中度狭窄、重度狭窄阳性率差异比较有统计学意义(P<0.05)。头颈部CT、颈动脉超声、联合诊断血管性帕金森病动脉斑块类型脂质型、纤维型、钙化型、脂质纤维型阳性率差异比较有统计学意义(P<0.05)。结论CT头颈部成像联合颈动脉超声检查能明显提升血管性帕金森患者的诊断价值,具体表现在能明确病变位置、颈动脉狭窄程度、疾病分期上,推荐使用。Objective To investigate the diagnostic value of CT cerebral and carotid arteriography combined withcarotid artery ultrasound in patients with vascular Parkinson's disease.Methods A total of 100 patients with vascular Parkinson's disease admitted to our hospital from March 2018 to October 2019 were selected.All patients received the cerebral and carotid arteriography and carotid artery ultrasound,respectively.Taking digital subtraction angiography(DSA)as"gold standard",the diagnostic value of the three examination methods for lesion site,modified Hoehn-Yahr staging,head carotid stenosis and carotid plaque type was analyzed.Results The positive rate of modified Hoehn-Yahr staging in phase 0,phase 1,phase 2,phase 3 and phase 4 by three examination methods was significantly different,which was the highest by combined detection,followed by carotid artery ultrasound,and CT cerebral and carotid arteriography,with statistic difference(P<0.05).The positive rate of subcortical white matter,basal ganglia and thalamus by three examination methods was significantly different(P<0.05).The positive rate of normal carotid artery stenosis,mild stenosis,moderate stenosis,and severe stenosis by three examination methods was significantly different(P<0.05).The positive rate of lipid plaque,fibrosis,calcification and lipid fiber type by three examination methods was significantly different(P<0.05).Conclusion CT cerebral and carotid arteriography combined with carotid artery ultrasound can determine the location of the lesion,the degree of carotid stenosis,and the disease stage of patients with vascular Parkinson's disease,which is recommended.

关 键 词：CT头颈部成像 颈动脉超声 血管性帕金森病 血管 狭窄 分期 

分 类 号：R445.3[医药卫生—影像医学与核医学] R323.1[医药卫生—诊断学]