颈动脉粥样硬化老年患者的双源CT血管造影分析

Analysis of carotid atheromatous plaque by dual-source CT angiography

目的:探讨老年患者颈动脉粥样硬化斑块的性质、好发部位及管腔的狭窄程度。方法:对186例颈动脉粥样硬化的高危老年患者行颈动脉双源CT血管造影(DSCTA),将颈动脉DSCTA图像进行后处理。分析粥样硬化斑块的发生部位、性质以及血管狭窄的程度。结果:186例颈动脉粥样硬化高危老年患者中,122例(270处)可见粥样硬化斑块,检出率为65.6%,其中54.1%(66例,172处)为钙化性斑块,11.5%(14例,22处)为非钙化性斑块,34.4%(42例,76处)为混合型斑块;84例粥样斑块为多发性;粥样硬化斑块发生在颈动脉分叉处115处,颈内动脉颅外段65处,颈总动脉起始部位36处,颈总动脉中段29处,椎动脉25处。122例患者中83例可见血管狭窄,其中轻度狭窄32例、中度狭窄23例、重度狭窄18例、血管闭塞10例。结论:老年患者颈动脉粥样硬化斑块主要以钙化性斑块为主;颈动脉粥样硬化好发部位为颈动脉分叉处,其次为颈内动脉颅外段。双源DSCTA可清晰地评价颈动脉粥样硬化斑块发生的部位、性质和受累血管的狭窄程度。

Objective： To investigate the nature and usual location of carotid atheromatous plaque and stenosis of the involved carotid artery. Methods ： We performed dual-source CT angiography （DSCTA） for 186 old patients with high risk of atherosclerotic carotid artery and reconstructed the DSCTA images of the carotid arteries to analyze the nature and usual place of carotid atheromatous plaque and stenosis of the carotid artery induced by the problem. Results： Among the total number of cases, atheromatous plaque was detected in 122 （65.6%, 270 places）, of which 66 （54.1%, 172 places） were calcified, 14 （11.5%, 22 places） were soft, and 42 （34.4%, 76 places） exhibited a combined nature of both calcified and soft plaque; 84 cases had multiple atheromatous plaques, 115 plaques located in the bifurcation of the carotid artery, 65 in the extracranial vessel of the internal carotid artery, 36 in the initial part of the carotid artery, 29 in the common carotid artery and 25 in the vertebral artery. Of the 122 cases,83 had stenosis, 32 mild, 23 moderate, 18 severe and 10 with occlusion. Conclusion： Calcified plaque mainly develops in the carotid artery of old patients, while carotid atheromatous plaque is chiefly located in the bifurcation of the carotid artery, and next the extracranial vessel of the internal carotid artery. Dual-source CT angiography can be used to clearly determine the nature and location of carotid atheromatous plaque and stenosis of the involved carotid artery.