颅外颈动脉螺旋CT血管造影的临床应用

The evaluation of extracranial carotid artery diseases by SCTA

目的 初步探讨螺旋CT血管造影(SCTA)及三维重建对颈动脉病变的诊断价值。 方法 10例颅外颈动脉血管SCTA及三维重建。三维重建方法包括:多平面重建(MPR)、表面遮盖成像(SSD)和最大强度投影(MIP)。 结果 7例缺血性脑梗塞,2例左侧颈总动脉近段及1例双侧颈总动脉近段SSD及MIP成像均显示管腔明显狭窄、表面不规则,狭窄段血管周围低密度血栓及钙化影。4例SSD及MIP显示双侧颈总动脉、颈内外动脉近中段大小形态正常。1例SSD及MIP成像显示双侧颈总动脉分叉处呈梭形瘤样扩张。1例SSD及MIP成像显示右侧颈总动脉近端迂曲扩张。1例左颈总动脉狭窄血管内支架术后,MPR,SSD及MIP显示左颈总动脉狭窄血管内支架整体形态及通畅情况。 结论 SCTA及三维重建显示颅外颈动脉狭窄、扩张等外部形态变化及血管内支架术后通畅情况,作为缺血性脑梗塞颈动脉狭窄筛选检查方法有一定限度。

Objective To evaluate the extracranial carotid artery diseases by SCTA. Methods 10 cases of extracranial carotid artery were examined by SCTA. MPR、SSD and MIP as three-dimential models. Results In 7 cases of cerebral ischemia embolism, SSD and MIP could demonstract the left common carotid artery stenosis (n=2), the left and right common carotid artery stenosis (n=1), with irregular shape, plaque or calcified plaque. the left and right common carotid arteries, left and right internal, external carotid arteries were demon-stracted normal by SSD and MIP(n=4). SSD and MIP could demonstract the dilation common carotid arteries(n=2). The position, shape and patency of carotid artery stenosis after graft placement could be demonstracted by MRP、SSD and MIP(n=1). Conclusion SCTA play im-portal value in demonstracting the shape of carotid artery and following up of endovascular steal implaint. It has limite value as a screening technique to evaluate carotid artery stenosis.