急性缺血性脑卒中患者颈部动脉双源CT血管造影分析

Analysis of Carotid Artery of Patients with Acute Ischemic Stroke by Dual-source Computed Tomographic Angiography

目的探讨急性缺血性脑卒中患者颈部动脉双源CT血管造影的改变特点。方法 71例急性缺血性脑卒中患者经磁共振检查在弥散加权像上呈高信号,分析该组患者在双源CT血管造影上颈动脉粥样硬化斑块分布特点、斑块性质及血管狭窄程度等,并与45例非缺血性脑卒中患者(对照组)相比较。结果 71例急性缺血性脑卒中患者中51例检出颈动脉粥样硬化斑块196个,其中最好发的部位为颈总动脉分叉处和主干,分别占52.0%及20.4%;斑块性质以混合斑块和软斑块为主,分别占52.0%(102/196)和27.0%(53/196);中到重度血管狭窄约占54例患者中的86.3%。与对照组比较,斑块检出率、斑块分布、斑块性质及血管狭窄程度两组差异具有统计学意义(P<0.05)。结论急性缺血性脑卒中患者颈动脉粥样硬化斑块性质以混合斑块和软斑块为主,其动脉狭窄常为中到重度。

Objective To investigate the changes on carotid artery of patients with acute ischemic stroke by dual source computed tomographic angiography （DS-CTA）.Methods From March 2009 to August 2010,71 patients with acute ischemic stroke （IS group） underwent magnetic resonance imaging,which showed high signals on diffusion-weighted images.The location of atherosclerotic plaques in carotid artery,the nature of plaques,and the grade of stenosis were analyzed by DS-CTA,and the results were further compared with 45 patients with non-ischemic stroke （control group）.Results In the IS group,196 atherosclerotic plaques in the carotid artery were detected in 51 patients;the commonest locations included carotid artery bifurcation （52.0%） and trunk （20.4%）.Most plaques were combined plaques [52.0% （102/196）] and soft plaques [27.0% （53/196）].Moderate and severe stenosis accounted for 86.3% in these 54 patients.The positive rate,nature,and location of plaques and the stenosis degree of artery were significantly differentbetween IS group and control group （all P0.05）.Conclusion The commonest plaques in the carotid artery of patients with acute ischemic stroke are combined plaques and soft plaques,which often cause moderate and severe stenosis.