能谱CTA在2型糖尿病合并症状性颈动脉粥样硬化的应用  

Application of Spectral CTA in Type 2 Diabetes Mellitus Patients with Symptomatic Carotid Atherosclerosis

作　　者：陈笑 刘杰[3] 王国华[1] 蔡晓艺 薛公博 王瑶[1] CHEN Xiao;LIU Jie;WANG Guohua;CAI Xiaoyi;XUE Gongbo;WANG Yao(Department of Radiology,Qingdao Hospital,University of Health and Rehabilitation Sciences(Qingdao Municipal Hospital);Graduate Department,Shandong First Medical University(Shandong Academy of Medical Sciences);Department of Outpatient,Qingdao Hospital,University of Health and Rehabilitation Sciences(Qingdao Municipal Hospital))

机构地区：[1]康复大学青岛医院(青岛市市立医院)放射科 [2]山东第一医科大学(山东省医学科学院)研究生部 [3]康复大学青岛医院(青岛市市立医院)门诊部

出　　处：《中国医学计算机成像杂志》2023年第3期290-294,共5页Chinese Computed Medical Imaging

摘　　要：目的:利用CT能谱成像分析2型糖尿病合并急性缺血性脑卒中患者的颈动脉粥样硬化特征。方法:回顾性分析我院收治的症状性颈动脉粥样硬化患者118例,包括糖尿病组63例,非糖尿病组55例。采用CT能谱成像技术区分颈动脉斑块类型,比较2组患者中各斑块的发生率和颈动脉狭窄情况。结果:糖尿病组共检出斑块208个,比较钙化斑块、纤维斑块、脂质斑块及混合斑块的能谱曲线斜率和有效原子序数均具有统计学差异(F=68.982、711.185,均P<0.001)。糖尿病组患者颈动脉狭窄发生率和狭窄程度高于对照组(P<0.05)。研究组钙化斑块和不稳定斑块的发生率明显高于对照组(P<0.05)。结论:CT能谱成像能有效区分斑块类型,评估斑块稳定性与颈动脉狭窄。糖尿病对颈动脉粥样硬化发生发展具有一定的相关性,应当积极控制血糖水平,减少脑血管不良事件的发生。Purpose:To analyze the characteristics of carotid atherosclerotic plaques in patients with type 2 diabetes mellitus and acute ischemic stroke using spectral CT imaging.Methods:A total of 118 patients with acute ischemic stroke and carotid atherosclerosis in our hospital were retrospectively analyzed,and divided into diabetic group(n=63)and non-diabetic group(n=55).The types of carotid plaques were distinguished by spectral CT imaging,so as to have a comparison between the two groups in incidence of plaques and stenosis of carotid artery.Results:A total of 208 plaques were detected in the diabetic group.There were significant differences in the energy spectrum slope and effective atomic number of calcified plaque,lipid plaque,fibrous plaque and mixed plaque in the diabetic group(F=68.982,711.185,all P<0.001).The incidence and degree of carotid artery stenosis in the diabetic group were higher than those in the control group(P<0.05).Diabetic patients had a significantly higher incidence of calcified plaque and unstable plaque than non-diabetic patients(P<0.05).Conclusion:Spectrum CT can be used to effectively distinguish the types of plaque,and evaluate the stability of plaque and carotid stenosis.Diabetes mellitus is associated with the development of carotid atherosclerosis,and the blood glucose level should be actively controlled to reduce the occurrence of cerebrovascular events.

关 键 词：CT能谱成像 糖尿病 缺血性脑卒中 颈动脉粥样硬化斑块 类型 

分 类 号：R445.3[医药卫生—影像医学与核医学]