256层螺旋CT血管造影术评价颈动脉溃疡斑块

Evaluation of carotid plaque ulceration with 256-slice CT angiography

目的探讨256层螺旋CTA评价颈动脉溃疡斑块的价值。方法回顾性分析136例颈动脉粥样硬化患者的256层螺旋CTA资料,观察斑块的分布情况及颈动脉管腔狭窄程度,并分析斑块的构成成分,重点分析其中溃疡斑块的相关情况,并分析溃疡斑块与临床症状的相关性。结果 136例患者中共发现颈动脉斑块452个,其中溃疡斑块78个,溃疡发生率为17.26%(78/452),位于颈总动脉14个,分叉部32个,颈内动脉13个,颈外动脉19个;纤维斑块7个,脂肪斑块49个,钙化斑块3个,混合性斑块19个;溃疡斑块导致管腔轻、中、重度狭窄及闭塞分别为7、29、34和8个。溃疡斑块与脑缺血症状存在统计学关联(OR=3.433,P<0.01)。结论 256层螺旋CTA可无创地评价颈动脉溃疡斑块的特征,具有较高应用价值。

Objective To investigate the value of 256-slice CT angiography for assessing plaque ulceration in carotid artery. Methods CTA data of 136 patients with carotid artery atherosclerosis were retrospectively analyzed. The degree of carotid artery stenosis, the positional distribution and composition of the carotid plaque especially the plaque ulceration were studied, and the correlation between plaque ulceration in carotid artery and the symptoms of cerebral ischemia was ana lyzed. Results Totally 452 carotid atherosclerotic plaques including 78 plaque ulcerations were found in 136 patients, the incidence rate of plaque ulceration was 17.26%（78/452）. There were 14 plaque ulcerations located in common carotid artery, 32 in carotid artery bifurcation, 13 in internal carotid artery and 19 in external carotid artery. The plaque ulcerations included fibrous plaques （n=7）, lipid plaques （n=49）, calcified plaque （n=3） and mixed plaques （n=lg）. The plaque ulcerations led to mild, moderate, severe stenosis and blocking of carotid artery were 7, 29, 34 and 8, respectively, plaque ulceration in carotid artery was statistically associated with symptomatic ischemic events （OR= 3. 433, P〈0.01）. Conclusion 256-slice CTA is a noninvasive method which can be used to assess the characteristics of plaque ulceration in carotid artery with high application value.