TCD和CTA对颈内动脉支架植入前后的评估价值

THE VALUE OF TRANSCRANIAL DOPPLER AND CT ANGIOGRAPHY IN SCREENING EXTRACRANIAL CAROTID ARTERIAL STENOSIS AND FOLLOW-UP REVIEW AFTER A STENT PLACEMENT

目的探讨经颅多普勒超声(TCD)和CT血管造影术(CTA)对颈内动脉颅外段狭窄的筛查价值和颈动脉支架植入术(CAS)后随访中的价值。方法对行TCD与CTA筛查、并经数字减影血管造影(DSA)证实的108例颈内动脉颅外段狭窄病人行CAS。术后6个月病人均行TCD检查,24例病人行CTA与DSA检查,55例病人行CTA检查,29例病人行DSA检查。将TCD、CTA结果与DSA结果相比较。结果以DSA结果为金标准,TCD和CTA与之比较,术前诊断颈内动脉颅外段狭窄一致性极好。支架植入后应用TCD与CTA随访,二者与DSA随访结果的符合率达100%。结论 TCD与CTA对颈内动脉颅外段狭窄的诊断可靠性好,二者联合应用可在支架治疗前后的评估中替代DSA。

Objective To assess the value of transcranial Doppler（TCD） and CT angiography（CTA） in screening extracranial carotid arterial stenosis（CAS） and in follow-up study for patients undergoing carotid artery stent placement（CASP）. Methods A CASP was performed in 108 patients with extracranial CAS,who were screened by TCD and CTA,and confirmed by digital subtraction angiography（DSA）.At six months after stenting,all the patients underwent TCD,24 received both CTA and DSA,55 had a CTA,and 29 had a DSA.The findings of TCD and CTA were compared with that of DSA. Results Taking DSA result as a gold standard,the results of TCD and CTA were compared with DSA,the consistency of preoperative diagnosis of extracranial CAS was excellent.Post-stenting follow-up using TCD and CTA,both of the methods were 100% coincident with the follow-up findings of DSA. Conclusion Both TCD and CTA are reliable in identification of extracranial CAS,a combination of this two techniques can be used to replace DSA in patient selection and postoperative review for those with this condition.