多层CT评价TIA患者颈动脉狭窄及卒中预测的意义

The Multislice CT Evaluation of Carotid Artery Stenosis in Patients with TIA

目的探讨颈动脉多层CT血管成像(CTA)及脑灌注成像(CTP)评价短暂性脑缺血发作(TIA)患者颈动脉狭窄的临床意义及随访价值。资料与方法短期内行CT平扫、颈动脉CTA的TIA患者46例,其中25例行脑CTP,评价颈内动脉狭窄的发生率、与灌注异常的相关性及部分病例随访情况。选择23例符合实验组年龄段且无TIA发作史、头CT平扫无异常的志愿者作为对照组。结果46例中,平扫未见异常17例,29例有腔隙性脑梗死,其中多发13例。CTA显示颈内动脉狭窄38支,轻度11支(28.9%),中度20支(52.6%),重度7支(18.4%)。对25例行脑CTP,发现异常22例,正常3例。随访15例中11例一年中发生卒中或TIA。结论颈动脉CTA结合脑CTP能及时判断颈内动脉病变的存在及对脑血流的影响,并预测卒中发生的危险,对TIA患者的早期临床干预有重要的指导意义。

Objective To explore the clinical application and follow up value of CT angiography （CTA） and CT perfusion imaging （CTP） in carotid artery, stenosis in patients with TIA. Materials and Methods 46 pa- tients with TIA were performed with CT plain scan and CTA. Among them, there were 25 cases with CTP. The degree and location of artery stenosis, and its correlation with abnormal CTP were evaluated. 23 persons without TIA and negative re- sult by CT plain were regarded as control group. Results Among the 46 cases, there were 17 normal cases and 29 cases with lacunar infarction, 13 cases were multiple arteries involved. CTA showed that 38 internal carotid arteries with steno- sis, the mild stenosis in 11 arteries （28.9%）, the moderate stenosis in 20 arteries （52.6%）, the severe stenosis in 7 ar- teries （18.4%）. 22 patients had abnormal CT perfusion and 3 had normal CT perfusion results in 25 cases with CTP. Conclusion Carotid artery CTA combined with CTP can reveal the internal carotid artery disease, and also can predict the stroke, which is helpful to interfere in patients with TIA in early stage.