CTA对症状性颈动脉狭窄脑梗死复发预后的评估  

CTA evaluates the prognosis of recurrence of cerebral infarction in symptomatic carotid artery stenosis

作　　者：单士超 SHAN Shichao(Yellow River Central Hospital of Yellow River Water Conservancy Commission,Zhengzhou 450000,China)

机构地区：[1]黄河水利委员会黄河中心医院,河南郑州450000

出　　处：《中国实用神经疾病杂志》2022年第9期1086-1090,共5页Chinese Journal of Practical Nervous Diseases

摘　　要：目的分析多排螺旋CT血管造影(SCTA)对症状性颈动脉狭窄脑梗死复发的预后评价方法及意义。方法回顾性分析黄河中心医院2019-01—2021-12收治的50例症状性颈动脉狭窄患者复发脑梗死病例资料,统计责任血管的狭窄率及位置分布情况,评估多排螺旋CT血管造影在症状性颈动脉狭窄患者脑梗死复发预后评价的应用效能。结果脑梗死复发患者前循环责任血管及后循环责任血管左右两侧血管狭窄分布情况无明显差异(P>0.05),双侧动脉均发生狭窄的情况更常见,单侧与双侧狭窄的差异有统计学意义;脑梗死复发患者责任血管多为颈总动脉和颈内动脉,单侧责任血管重度狭窄或闭塞时复发脑梗死的风险较高;复发梗死灶责任血管的影像学原始图像均显示责任血管的后端对比剂染色范围和浓度明显小于前端正常区域,提示管腔内血流量减少,责任血管支配区的脑组织局部脑供血不足,且该供血不足区域与再发梗死灶区域部分重合或完全重合。结论症状性颈动脉狭窄患者的头颈部联合CTA检查结果应更多关注双侧动脉多发性狭窄,尤其是单侧颈总动脉和颈内动脉的重度狭窄或闭塞,此类患者复发脑梗死的风险相对较高。Objective To analyze the prognosis evaluation method and significance of multi-row spiral CT angiography(SCTA)on the recurrence of cerebral infarction in patients with symptomatic carotid artery steno⁃sis.Methods Retrospectively analyzed the case data of 50 patients with symptomatic carotid artery stenosis from January 2019 to December 2021 in Yellow River Central Hospital,and the stenosis rate and location distribution of responsible blood vessels were statistically analyzed,and the effectiveness of multi-row spiral CT angiography in the prognosis evaluation of cerebral infarction recurrence in patients with symptomatic carotid artery stenosis was evaluated.Results There was no significant difference in the distribution of blood vessel stenosis on the left and right sides of the anterior circulating responsible vessels and the posterior circulating responsible vessels in pa⁃tients with recurrent cerebral infarction,P>0.05,and stenosis of both arteries was more common,and the differ⁃ence was statistically significant;Patients with recurrent cerebral infarction have common carotid arteries and in⁃ternal carotid arteries,and the risk of recurrent cerebral infarction is higher when the unilateral responsible ves⁃sels are severely narrowed or occluded;The original imaging images of the responsible vessels of the recurrent in⁃farction focus show that the posterior contrast agent staining range and concentration of the responsible vessels are significantly smaller than the frontal normal area,indicating a decrease in intraluminal blood flow,insufficient lo⁃cal cerebral blood supply to the brain tissue in the responsible vascular innervation area,and the insufficient blood supply area partially or completely coincides with the recurrent infarction foci.Conclusion Combined head and neck CTA findings in patients with symptomatic carotid artery stenosis should pay more attention to the incidence of multiple stenosis of bilateral arteries,particularly severe stenosis or occlusion of the unilateral com⁃mon ca

关 键 词：脑梗死 螺旋CT血管造影 数字减影血管造影 颈部血管超声 颈总动脉 颈内动脉 

分 类 号：R743.33[医药卫生—神经病学与精神病学]