MD-CTA对颈动脉不同类型粥样斑块血管壁强化特征的研究

The Study of Enhancement Features of Vessel Wall with Different Style Plaque in Atherosclerotic Carotid Artery with MD-CTA

目的通过分析动脉粥样硬化(AS)血管壁的强化特征,评价血管壁强化程度与斑块稳定性之间的关系。资料与方法212例临床拟诊为颈部血管狭窄的患者接受了多层螺旋CT血管造影(MD-CTA)检查。根据颈动脉有无AS斑块分为病例组和对照组。分析斑块的类型并测量邻近血管壁的强化程度,评价管壁强化特征与斑块稳定性之间的关系。结果病例组102例,共检出斑块145处,43例发生在双侧,59例发生在单侧。其中富含脂质的斑块16处,纤维化斑块34处,钙化斑块95处。相应的血管壁强化程度:富含脂质斑块为(33.63±7.02)HU,纤维化斑块为(25.21±7.54)HU,钙化斑块为(22.67±4.08)HU。而110例对照组血管壁强化程度为(26.45±6.47)HU。统计学分析显示富含脂质斑块组与对照组之间差异有统计学意义(t=4.11,P=0.0001);纤维斑块组和对照组之间差异无统计学意义(t=0.94,P=0.345);钙化斑块组则明显低于对照组(t=5.07,P<0.05)。富含脂质斑块的强化程度与管壁强化程度之间存在显著性相关(r=0.89,P<0.01)。结论AS血管壁强化程度与斑块的稳定性之间存在相关性,血管壁强化程度越高提示斑块稳定性越差。

Objective To assess the correlation of atherosclerosis （AS） plaque stability and enhancement Features of the： vessel wall by analysis AS vessel wall with Multidetector spiral CT angiography （ MDCTA ） . Materials and Methods 212 patients suspected of carotid artery stenosis were examined with MDCT angiography. All cases were divided into the experimental group and control group according to whether having AS plaque or not. The enhancement degree of vessel wall and modalities of AS plaque were analyzed in carotid artery. The relationship of AS plaque stability and enhancement features of the vessel wall was evaluated. Results There were 102 cases in the experimental group and 145 plaques were de- tected, included 16 lipid rich plaques, 34 fibrous plaques and 95 calcified plaques. The 43 cases had plaques in both carotid artery and 59 cases had plaque in single side. The intensity degree of vessel wall after enhancement was （33.63 ± 7.02） HU in lipid rich plaques and （25.21 ± 7.54）HU in fibrous plaques and （22.67 ± 4.08 ）HU in calcified plaques, but the intensity degree of vessel wall was （26. 45 ±6.47HU） in control group. There was significant difference between the lipid rich plaque and the control group （ t = 4.11, P = 0. 0001 ）, but it was not significant difference between the fibrous plaque and the control group （t = 0.94, P = 0. 345）. The density in calcified plaque group was obviously lower than that in the control group （ t = 5.07, P 〈 0.05）. The coefficient of correlation was 0.89 between the lipid rich plaque and the intensity degree of vessel wall（ P 〈 0.01 ）. Condusion There is significant correlation between intensity degree of vessel wall after enhancement and stability of plaque in AS on CT angiograms, which has important imphcations for the prediction of plaque stability. The higher intensity degree of vessel wall is, the worse stability of plaque is.