颈动脉大动脉炎64层螺旋CT影像表现

Diagnosis of Takayasu's Arteritis Affecting Carotid Arteries with Multi-slice Spiral CT

目的探讨64层螺旋CT诊断颈动脉大动脉炎的临床价值。方法分析并比较20例颈动脉大动脉炎患者(病例组)和10例无明显颈动脉血管病变和脑神经症状患者(对照组)的颈动脉CT血管成像(CTA)表现。结果颈动脉增强扫描结合三维重建方法可清晰显示大动脉炎患者颈动脉管腔的改变,表现为狭窄、闭塞、扩张及瘤样改变。病例组患者颈动脉的管壁厚度较对照组明显增厚[(0.36±0.13)cmvs.(0.03±0.02)cm,P<0.05],活动期组患者的颈动脉管壁厚度亦较非活动期患者明显增厚[(0.44±0.09)cmvs.(0.24±0.10)cm,P<0.05]。结论大动脉炎的重要CT征象是动脉壁增厚,CTA可同时显示管腔及管壁情况,颈动脉管壁厚度可能与疾病活动性相关。

Objective To explore changes in the carotid arteries in Tarkayasu arteritis （TA） with computed tomographic angiography （CTA）. Methods The common carotid artery intima-medial thickness （CCA-IMT） in 20 common carotid arteries （CCAs） in 10 controls and 40 CCAs in 20 patients with TA were analyzed and compared. Results Contrast-enhanced CT scanning combined with the application of 3D reconstruction clearly showed the carotid vascular luminal abnormalities, such as stenosis, occlusion, dilation, and aneurysm formation. CCA-IMT increased in all the patients with TA affecting carotid arteries. CCA-IMT was significantly larger in the patients than in controls [ （0.36 ± 0. 13 ） cm vs. （0.03 ± 0.02 ） cm, P 〈 0. 05 ], and was significantly larger in patients with active diseases than in those without active diseases [（0.44±0.09） cm vs. （0.24±0.10） cm, P〈0.05]. Conclusion CCA-IMT increases in TA affecting carotid arteries, especially in active diseases.