颈动脉CTA对颈动脉狭窄脑梗死患者颈动脉斑块的评估价值  

Evaluation value of carotid artery CTA for carotid artery plaque in patients with carotid artery stenosis complicated by cerebral infarction

作　　者：代雪莲 王会林 刘海林 任向阳 段智慧 Dai Xuelian;Wang Huilin;Liu Hailin;Ren Xiangyang;Duan Zhihui(Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang 471000,China)

机构地区：[1]郑州大学附属洛阳中心医院,洛阳471000

出　　处：《中国实用医刊》2024年第24期61-63,共3页Chinese Journal of Practical Medicine

摘　　要：目的探讨颈动脉CT血管成像(CTA)对颈动脉狭窄脑梗死患者颈动脉斑块的评估价值。方法回顾性抽取2019年10月至2020年12月于洛阳市中心医院血管外科住院并行颈动脉内膜剥脱术的49例颈动脉狭窄脑梗死患者为研究对象, 术前均行颈动脉CTA检查, 术后收集患者颈动脉斑块标本行常规染色及Movat特殊染色, 以术后病理检查结果为金标准, 评价颈动脉CTA对颈动脉斑块的评估价值。结果术后病理检查结果显示, 纤维帽不完整3个, 斑块溃疡形成10个, 斑块内血栓形成4个, 斑块钙化26个, 新生血管6个, 不稳定斑块23个。以术后病理检查结果为金标准, 颈动脉CTA诊断易损斑块的敏感度为5.7%, 特异度为87.5%;诊断钙化斑块的敏感度为100%, 特异度为100%;诊断斑块溃疡形成的敏感度为95.3%, 特异度为97.4%;诊断斑块溃疡伴出血的敏感度为23.4%, 特异度为89.4%。颈动脉CTA与颈动脉斑块病理检查诊断不同类型斑块的一致性较好, Kappa值为0.773, 颈动脉CTA与颈动脉斑块病理检查对易损斑块和溃疡斑块诊断的一致性一般, Kappa值分别为0.604、0.609。结论颈动脉CTA技术被认为在诊断颈动脉狭窄方面是首选, 其可以从不同平面、角度显示血管横断面情况, 还能够较好地识别颈动脉斑块的性质、分布及稳定性。Objective To investigate the evaluation value of carotid artery computed tomography angiography(CTA)for carotid artery plaque in patients with carotid artery stenosis complicated by cerebral infarction.MethodsForty-nine patients with carotid artery stenosis complicated by cerebral infarction,who underwent carotid endarterectomy in the Vascular Surgery Department of Luoyang Central Hospital from October 2019 to December 2020 were retrospectively selected as the research subject.All patients underwent carotid artery CTA examination preoperatively.Carotid artery plaque specimens were collected from these patients and subjected to routine staining and Movat’s special staining.The postoperative pathological examination results served as the gold standard to assess the diagnostic value of carotid artery CTA in evaluating carotid artery plaque.ResultsThe postoperative pathological examination results revealed that 3 fibrous caps were incomplete,10 plaque ulcers were present,4 intra-plaque thromboses occurred,26 plaques were calcified,6 lesions were neovascularized,and 23 lesions were identified as unstable plaques.Using the postoperative pathological examination results as the gold standard,carotid artery CTA demonstrated a sensitivity of 5.7%and a specificity of 87.5%for diagnosing vulnerable plaques;for calcified plaques,the sensitivity and specificity were both 100%;however,in diagnosing plaque ulceration,the sensitivity was 95.3%and the specificity was 97.4%.Additionally,for diagnosing plaque ulcers with bleeding,the sensitivity of carotid artery CTA was 23.4%and the specificity was 89.4%.The consistency between carotid CTA and carotid plaque pathological examination in diagnosing different types of plaques was good,with a Kappa value of 0.773.The consistency between carotid CTA and carotid plaque pathological examination in diagnosing vulnerable plaques and ulcerated plaques was moderate,with Kappa values of 0.604 and 0.609,respectively.ConclusionsCarotid artery CTA technology is considered the first choice in di

关 键 词：颈动脉狭窄 颈动脉 CT血管成像 急性脑梗死 Movat特殊染色 易损斑块 

分 类 号：R74[医药卫生—神经病学与精神病学]